抗DNA酶B在风湿热诊断中的应用

目的评估Ａ组溶血性链球菌感染的血清学测定方法对诊断风湿热的临床价值。方法采用抗ＤＮＡ酶Ｂ微量法和自制试剂测定急性风湿热８７例、活动期风湿性心脏病２０２例病人血清的抗ＤＮＡ酶Ｂ抗体，与抗溶血素Ｏ抗体（ＡＳＯ）对照研究。结果在急性风湿热组，抗ＤＮＡ酶Ｂ阳性占７２４％，和ＡＳＯ测定阳性６７８％比较，差异无显著意义（Ｐ＞００５）；在活动期风湿性心脏病组，抗ＤＮＡ酶Ｂ阳性占８３７％，明显超过ＡＳＯ的４７０％阳性，其差异有非常显著意义（Ｐ＜０００１）。抗ＤＮＡ酶Ｂ试验结合ＡＳＯ测定，在急性风湿热组和活动期风湿性心脏病组的阳性例数分别占９０８％和８８６％。结论抗ＤＮＡ酶Ｂ试验对急性风湿热和风湿性心脏病活动期的诊断有重要临床价值，与ＡＳＯ结合检测可提高诊断率。

The application of anti DNase B microtitration test in the diagnosis of acute rheumatic fever and rheumatic heart disease activity recurrence

Objective To evaluate diagnostic value of anti deoxyribonuclease B microtitration test in rheumatic fever. Methods Anti DNase B antibodies of 87 patients with acute rheumatic fever (ARF) and 202 rheumatic heart disease patients with rheumatic activity (ARHD) were detected with anti DNase B antibody microtitration test,and compared with antistreptolysin "O"(ASO) test. Results The positive rate of anti DNase B (72.4%) was somewhat higher than that of ASO(67.8%) in ARF group, but there was no statistical difference ( P >0.05). The positive rate of anti DNase B(83.7%) was significantly higher than that of ASO(47.0%) in ARHD group ( P <0.05). The number of sera with elavated titers in at least one test increased to 90.8% in ARF group and 88.6% in ARHD group when the anti DNase B test was studied simultaneously with the ASO test.Conclusions Anti DNase B microtitration test may be an useful tool in the diagnosis of RF.The positive rate of anti DNase B test was higher than that of ASO in patients with ARHD.It is advantageous to perform more than one antibody test.