脑囊虫病患者脑脊液中一氧化氮及肿瘤坏死因子α水平研究

目的　探讨脑囊虫病患者各期脑脊液中的一氧化氮 (NO)、肿瘤坏死因子α(TNF α)的变化规律及它们在脑囊虫病中的作用机制。方法　检测 4 9例明确诊断并依据MR分期 ,单发脑实质内囊虫的脑囊虫病患者和 2 0名对照者脑脊液中NO、TNF α水平。结果　NO在脑囊虫病的Ⅰ期显著降低而TNF α水平呈显著升高 ,NO、TNF α于Ⅱ期、Ⅲ期 (整个退变死亡期 )均表现为高水平 ,Ⅳ期恢复正常 ,NO和TNF α存在高度正相关关系。结论　在单发脑实质内囊虫病中NO、TNF α可能参与杀虫作用 ,其免疫调节与杀虫机制存在着动态平衡 ,参与感染控制     

脑囊虫病人血清、脑脊液中抗体在MRI各期的变化

目的 检测脑囊虫病人血清和脑脊液中抗体在MRI各期的变化。方法 用抑制性ELISA法检测血清及脑脊液中的抗体。同时根据MRI表现将病例分为活动期、退变期、非活动期。结果 在69个病例中，脑脊液中抗体阳性率分别是：活动期75．00％，退变期62．50％，非活动期17.24％；血清中是81．25％、16．67％、22．22％。在相应各期中，脑脊液和血清抗体阳性率无显著性差别。结论 在影像学的不同时期抗体阳性率存在明显的变化。     

单克隆抗体反向IHAT检测囊虫病循环抗原

应用抗猪囊虫抗原的单克隆抗体反向间接血凝试验（ＩＨＡＴ），对临床确诊的囊虫病患者进行了血清循环抗原（ＣＡｇ）的检测，阳性率为５１．１４％（６７／１３１）。对１９例脑型囊虫病患者同时测定了血清和脑脊液中的ＣＡｇ，阳性率分别为４７．３６％和７８．９４％，总阳性率为８４．２１％。对治疗０．５３后的１９例患者检测时，血清和脑脊液中ＣＡｇ均呈阴性反应，而检测抗体仍呈阳性反应。５０例正常人、４９例其它寄生虫病及５例其它脑部疾病患者脑脊液的ＣＡｇ均呈阴性反应。结果提示：测定ＣＡｇ对囊虫病活动性感染的诊断及疗效判定均具有一定的实用价值。     

双单抗夹心ELISA法检测脑囊尾蚴病血清特异性免疫复合物

目的 :建立双单抗夹心酶联免疫吸附试验法检测脑囊尾蚴病患者血清中特异性免疫复合物。方法 :用抗人IgG单抗包被 ,捕获血清中特异性IgG型免疫复合物 ,通过酶标抗囊尾蚴单抗结合物显色 ,测其OD值。结果 :用本方法测得患者特异性免疫复合物阳性率为 5 3.3 % ,明显高于正常对照组 (P <0 .0 0 5 ) ;循环抗原、抗体皆阴性患者 ,免疫复合物的阳性率为 5 0 % ,与各组相比差异有显著性 (P <0 .0 0 5 ) ;且免疫复合物的检出率明显高于循环抗原的检出率 (P <0 .0 0 5 )。结论 :本法对囊尾蚴病的诊断有重要的临床价值 ,尤其对抗原、抗体皆阴性患者意义更大     

Computerized axial tomography for the diagnosis of cerebral cysticercosis

Summary Computerized Axial Tomography (CAT) has proved extremely useful for the diagnosis of cerebral cysticercosis. The calcified small, multiple, and scattered cysts provide a typical image on CAT.The collection of non-calcified cysts in the subarachnoid spaces (racemose form) or in the ventricles may produce areas of low density similar to that of the cerebrospinal fluid. The dilatation of the ventricular system, extreme degrees of hydrocephalus, areas of cerebral atrophy, and other related changes induced by the cysts in the subarachnoid spaces are also clearly shown in the CAT. Four personal cases are reported.     

脑囊虫病160例的CT分析

目的 :为正确诊断脑囊虫病及合理治疗提供依据。方法 :对 160例脑囊虫病 CT进行分析。结果 :根据 CT检查结果将脑囊虫病分为脑实质型、脑室型、脑膜型和混合型等 4型 ;其中脑实质型又分轻度、中度、重度 3类 ,轻度预后好 ,重度预后差。结论 :脑囊虫病病灶的部位和数量与病情的轻、重及预后有关。 CT检查对脑囊虫病的诊断具有重要价值。     

Detection of IgG in cerebrospinal fluid for diagnosis of neurocysticercosis: evaluation of saline and SDS extracts from Taenia solium and Taenia crassiceps metacestodes by ELISA and immunoblot assay

We compared saline (S) and sodium dodecyl sulphate (SDS) extracts from Taenia solium (homologous species - HO) and Taenia crassiceps (heterologous species - HE) metacestodes in order to detect IgG by ELISA and immunoblot assay (IBA) in cerebrospinal fluid (CSF) for the diagnosis of human neurocysticercosis (NC). CSF samples were obtained from 93 patients. Of these, 40 had NC, five had a diagnosis of probable NC, nine had central nervous system schistosomiasis or strongyloidiasis and 39 had other neurological alterations. Samples were analysed by ELISA and the results were compared with IBA in all samples with confirmed and probable NC diagnosis, in all samples with other central nervous system parasitic infection, and in 10 of those with another neurological alterations. ELISA sensitivity was 100%, 85%, 95% and 87.5% for the S-HO, S-HE, SDS-HO and SDS-HE extracts, respectively, and ELISA specificity was 100% for S-HO, S-HE, SDS-HO extracts and 97.9% for SDS-HE antigen. Immunodominant peptides detected by IBA were, by decreasing percentage of recognition: 64-68 and 45 kDa for S-HO; 108-114, 92-95, 64-68, 83 and 88 kDa for S-HE; 64-68, 108-114, 77 and 86 kDa for SDS-HO; and 108-114, 88 and 92-95 kDa for SDS-HE. Overall the homologous antigenic extracts showed higher sensitivity than the heterologous extracts in the diagnosis of NC in CSF samples. The heterologous extracts contained most of the immunodominant peptides presented in the homologous extracts, which are recognized by IgG antibodies in CSF samples.     

人囊虫病T淋巴细胞亚群及血清IgE的变化

应用直接ＳＰＡ菌花环法对２７例囊虫病患者外周血Ｔ淋巴细胞亚群进行检测，同时用ＥＬＩＳＡ法测定血清ＩｇＥ水平。发现患者ＣＤ３＋，ＣＤ４＋细胞的百分率明显降低，ＣＤ４／ＣＤ８比值明显下降，血清ＩｇＥ含量显著升高。经分析，患者ＣＤ４细胞、ＣＤ４／ＣＤ８比值与ＩｇＥ对数值呈负相关。揭示囊虫病患者Ｔ细胞亚群比例失调，免疫功能紊乱。本文对可能的免疫调节机制和发病机理进行了探讨。