三种登革热抗体检测方法的临床对比研究

目的 比较酶联免疫吸附法（ELISA）、免疫斑点法（DIBA）和免疫层析法（ICT）检测登革热抗体的敏感性、特异性及其他优缺点。方法 用ELISA、DIBA和ICT同时检测登革热患者和流行性出血热、疟疾、乙脑、流感、钩体等其他发热患者的DV-IgM／Igg抗体，比较测试结果。结果 用ICT法（澳大利亚PANBIO Limited）检测登革热患者DV-IgM的阳性率为60．4％（32／53），DV-IgG无1例阳性；检测非登革感染发热患者DV-IgM的假阳性率为14．7％（5／34），DV-IgG无1例阳性。用ELISA法（德国GMBH）检测登革热患者DV-IgM的阳性率为66．0％（35／53），DV-IgG的阳性率为70．2％（40／57）；检测非登革感染发热患者DV-IgM的假阳性率为35．3％（12／34），DV-IgG的假阳性率为8．8％（3／34）。用ELISA法（澳大利亚PANBIO Limited）检测登革热患者DV-IgM的阳性率为75．5％（40／53），DV-IgG的阳性率为49．1％（28／57）；检测非登革感染发热患者DV-IgM的假阳性率为11．8％（4／34），DV-IgG无1例阳性。用DIBA法（新加坡Genelabs Diagnostics）检测登革热患者DV—IgM的阳性率为84．9％（45／53），DV—IgG的阳性率为64．9％（37／57）；检测非登革感染发热患者DV-IgM的假阳性率为47．1％（16／34），DV-IgG无1例阳性。结论 通过比较显示，ICT法检测DV-IgM抗体适合在登革热爆发流行期间用作疫区基层医疗单位的早期初筛试验；ELISA法检测DV-IgM／IgG抗体适合在普查及大批量标本检测时使用；DIBA法检测DV-IgM抗体不适合作为初筛试验；DIBA法检测DV-IgG抗体适合在登革热散发期间使用，可作为登革病毒感染的确证实验。

Comparison of Three Methods for Detecting Dengue Virus Antibodies

Objective Comparing the sensitivity,the specificity,and the application value of three methods of detecting dengue virus antibody: dengue virus IgM/IgG rapid immununochromatographic test(ICT),dengue virus IgM and IgG enzyme linked immunosorbent assay(ELISA),and dengue virus IgM and IgG dot immunobinding assay(DIBA). Methods ICT,ELISA,and DIBA methods were used to detect the anti-dengue virus IgM and IgG antibodies in the serum of patients with dengue fever(DF),epidemic hemorrhagic fever(EHF),malaria,epidemic encephalitis B,influenza and leptospirosis. The results were compared. Results Using the IgM-ICT detection kit(Australia,PANBIO Limited),there were 32 positive in 53 serum samples from dengue virus infected patients,but none were positive by IgG-ICT detection;there were 5 positive in 34 serum samples from other patients,but none were positive by IgG-ICT detection. Using the IgM-ELISA detection kit(German,NovaTec Immundiagnostica GMBH),there were 35 positive in 53 serum samples from dengue virus infected patients,and 40 positive in 57 serum samples by IgG-ELISA detection;there were 12 positive in 34 serum samples from other patients,and 3 positive in IgG-ELISA detection. Using the IgM-ELISA detection kit(Australia,PANBIO Limited),there were 40 positive in 53 serum samples from dengue virus infected patients,and 28 positive in 57 serum samples by IgG-ELISA detection;there were 4 positive in 34 serum samples from other patients,but none were positive by IgG-ELISA detection. Using the IgM-DIBA detection kit(Singapore,Genelabs Diagnostics),there were 45 positive in 53 serum samples from dengue virus infected patients,and 37 positive in 57 serum samples by IgG-DIBA detection;there were 16 positive in 34 serum samples from other patients,but none were positive by IgG-DIBA detection. Conclusion By comparing the three methods of detecting dengue virus antibody, DIBA detection kit is the first choice and the other two kits are of second choice. ICT is a simple and rapid method which can be carried out without using special instrument,so it is applicable to different laboratories.