血吸虫循环抗原检测及疗效考核价值

采用单克隆抗体(McAb)S31/32双夹心ELISA法检测感染不同寄生虫病人血清中循环抗原(CAg)427份,其中慢性血吸虫病188例,阳性检出率为95.2%,晚期血吸虫病阳性率4.5%(2/44),正常53人假阳性率5.7%.测定其他寄生虫感染患者及肝炎病人,除发现肺吸虫病、旋毛虫病和华枝睾吸虫病有交叉反应外,其它均呈阴性反应.同时,检测血吸虫病治疗前、后CAg,计495 份血清,慢性血吸虫病治疗前188例,阳性率95.2%,吡喹酮治疗后3、6、12和36个月,其阴转率分别为20.4%、31.9%、96.2%和87.7%.比较双夹心ELISA法和一步法ELISA检查CAg,无显著差异.测试结果提示,采用单抗S31/32建立的双夹心ELISA检测血吸虫循环抗原有很高的敏感性和良好的特异性,病人在治疗后一年其阴转率高,有很好的疗效考核价值.

STUDIES ON DETECTION OF CIRCULATING ANTIGEN AND EVALUATION OF TREATMENT EFFICACY IN SCHISTOSOMIASIS

Circulating antigen (CAg) in sera from 427 cases of different parasitic diseases was detected by S-ELISA with monoclonal antibody 31/32 against schistosome gut-associted antigen, the positive rates being 95.2%(179/188) in chronic infection of schistosomiasis,4.5% (2/44) in advanced infecton. CAg in sera from paragonimiasis, trichinelliasis,clonorchiasis patients and normal individuals were detected by S-ELISA,the cross or false positive rates being 20.0%,12.5%,11.6% and 5.7% respectively. No positive reaction were found with sera from patients of cysticercosis and hepatitis B. Altogether 307 serum samples of schisto-somiasis were selected for assessment of cure,CAg became negative 3,6,12 and 36 months after praziquantal treatment in 20.5%,31.9%,96.2% and 87. 8% patients respectively who showed negative fecal examination. The results indicated that the S-ELISA with McAb31/32 can be used for diagnosis of schistosomiasis japonica and evaluation of treatment efficacy.