检测血清和脑脊液中囊尾蚴循环抗原诊断脑囊虫病的研究

目的：用抗血清检测脑囊虫病患者血清和脑脊液（ Ｃ Ｓ Ｆ）中囊尾蚴循环抗原（ Ｃ Ａｇ）诊断脑囊虫病。方法：用 Ｓ Ｄ Ｓ Ｐ Ａ Ｇ Ｅ提纯的蛋白质分子量为 ６４ ｋ Ｄａ、５３ ｋ Ｄａ、３２ ｋ Ｄａ～３０ ｋ Ｄａ 的囊尾蚴抗原分别免疫家兔，制备相应的抗血清，以双夹心 Ｅ Ｌ Ｉ Ｓ Ａ 检测患者血清和 Ｃ Ｓ Ｆ中 Ｃ Ａｇ。结果：抗５３ ｋ Ｄａ 抗原抗血清对 ３２ 例脑囊虫病活动型患者血清和 Ｃ Ｓ Ｆ中 Ｃ Ａｇ 的检出率分别为９３．８％ 和９１．７％ ，１６ 例脑囊虫病非活动型患者仅１ 例 Ｃ Ｓ Ｆ Ｃ Ａｇ 阳性。 Ｃ Ａｇ 检出率明显高于用抗６４ ｋ Ｄａ、３２ ｋ Ｄａ～３０ ｋ Ｄａ 囊尾蚴抗原抗血清检测的结果（ Ｐ＜ ０．０５）。结论：抗５３ ｋ Ｄａ 囊尾蚴抗原抗血清检测活动型脑囊虫病患者血清和 Ｃ Ｓ Ｆ中的 Ｃ Ａｇ 敏感性较高，特异性较强，可用于活动型脑囊虫病的诊断和疗效考核。

DETECTION OF CIRCULATING ANTIGEN IN SERUM AND CEREBROSPINAL FLUID FOR DIAGNOSIS OF CEREBRAL CYSTICERCOSIS

AIM: To detect circulating antigen(CAg) in serum and cerebrospinal fluid(CSF) from patients with cerebral cysticercosis with specific antiserum by sandwich ELISA. METHODS: Antisera were prepared from rabbits immunized respectively with 3 antigens with molecule weights of 64 kDa, 53 kDa, 32 kDa-30 kDa extracted from Cysticercus cellulosae and purified by SDS-PAGE. RESULTS: When samples from patients were tested with antiserum against 53 kDa antigen, the CAg positive rate was 93.8% in serum and 91.7% in CSF of 32 patients with active cysticercosis, whereas only one positive was found in CSF in 16 patients with inactive cysticercosis. The detection rate of CAg was significantly higher with anti-53 kDa antiserum than with anti-64 kDa and anti-32 kDa-30 kDa antiserum. CONCLUSION: Sandwich-ELISA using antiserum against 53 kDa antigen to detect CAg was found to be a promising assay for diagnosis and evaluation of treatment efficacy of active cerebral cysticercosis in terms of its high sensitivity and specificity.