外斐氏OXk试验在恙虫病暴发调查的价值

目的证实河南省发生的不明原因发热、头痛、皮疹病人的病因。方法对可疑病人进行流行病学调查、用血清学、套式PCR方法检测病人血清抗体滴度、血清型及立克次体特异性基因片段。结果恢复期病人血清外斐氏OXk阳性率100%。11例病人的双份血清抗体呈4倍升高;恙虫病立克次体IFA检测lgM和lgG抗体,20份均为阳性,最高达1∶2560;恙虫病血清学分型G illiam 4例,Karp 6例,Kato 8例。套式PCR检测病人血标本中特异性R tDNA片段,3份阳性;结论外斐氏OXk试验简便、易行,适用于暴发疫情的定性。值得注意的是病人第1周阳性率较低,对高度怀疑恙虫病患者在第1周内OXk阴性,在第(2、3)周再作OXk试验,可以得到明确诊断。

The Value of Weil-Felix Test OXk Antibody Detection in Diagnosis of Tsutsugamushi Disease

Objective :To approve the reasons of fever,headache and tetter for some patients in Henan province.Methods: Carrying out epidemiological investigation on the patients and detecting the serum antibody titers,serological type and different gene band of Rickettsttsia from the patients with the serological survey and the nested-polymerase chain reaction.Results: The positive rate of OXk was 100% with Weil-Felix test for the convalescence patients.The antibody titers of the second serums were 4 times increased than that of the first serums in 11 cases.lgM and lgG were detected with Rickettsttsia IFA.20 specimens were found positive and the highest one was 1∶2560. After serologically typing,4 specimens were identified as Gilliam,6 were Karp and 8 Kato of 18 cases of tsutsugamushi disease.Specific RtDNA band was tested with nested-polymerase chain reaction and 3 cases were found positive.Conclusion: OXk Antibody detection with Weil-Felix test is simple,convenient and feasible.It is applicable to screen patients at grass roots.It should be pay attention to that the positive rate of the serum antibody is comparatively lower within a week.If the OXk serum antibody of suspect patients is negative within a week,the test should be done again after 2-3 week.