酶联免疫斑点法检测抗1型单纯疱疹病毒IgM分泌细胞在单纯疱疹病毒性脑炎早期诊断中的作用

目的 观察酶联免疫斑点法(ELISPOT)检测抗1型单纯疱疹病毒IgM(抗-HSV-1 IgM)分泌细胞在单纯疱疹病毒性脑炎(HSV-1脑炎)早期诊断中的作用并探讨其价值.方法 采用ELISPOT法和ELISA法分别检测患者脑脊液中的抗-HSV-1 IgM分泌细胞和抗-HSV-1 IgM,并对HSV-1腩炎23例、临床对照组40例进行回顾性分析,统计学处理采用Fisher精确检验法.结果 ELISPOT法检测HSV-1脑炎组9例患者2周内脑脊液中抗-HSV-1 IgM分泌细胞,8例阳性.敏感度为88.9%;临床对照组检测16例,15例阴性,特异度为93.8%.ELISA法榆测HSV-1脑炎组12例患者脑脊液2周内抗-HSV-1 IgM,2例阳件,敏感度为16.6%;临床对照组检测17例,15例阴性,特异度为88.2%.两种方法敏感度比较差异有统汁学意义(P<0.01).结论 应用ELISPOT法检测HSV-1脑炎患者脑脊液中抗-HSV-1 IgM分泌细胞优于 ELISA方法检测抗-HSV-1 IgM,具有更好的早期诊断意义.

The role of anti-herpes simplex virus-1 IgM secreting cells detection assay in the early diagnosis of herpes simplex encephalitis

Objective To investigate the role of anti-herpes ximplex virus (HSV)-1 IgM secreting cells detection assay in early diagnosis of herpes simplex encephalitis. Methods Twenty-three herpes simplex encephalitis cases and 40 control cases were included in this study. Anti-HSV-1 IgM secreting cells and anti-HSV-1 IgM were retrospectively tested in the patients' cerebrospinal fluid by enzyme-linked immunosorbent spot (ELISPOT) and enzyme-linked immunosorbent assay (ELISA), respectively. The data analysis was performed by using Fisher Exact Test. Results Using ELISPOT method for detection of 9 HSV-1 encephalitis patients' and 16 clinical control cases anti-HSV-1 IgM secreting cells within two weeks after disease onset, the sensitivity of ELISPOT for detecting anti HSV-1 IgM secreting cells in the cerebrospinal fluid was 88.9% (8/9) and the specificity was 93.8%(15/16). On the other hand, the sensitivity of ELISA for detecting anti-HSV-1 IgM in ccrebrospinal fluid was 16.6% (2/12) and the specificity was 88.2% (15/17) when using ELISA method for detection of 12 HSV-1 encephalitis patients' and 17 clinical control cases's anti-HSV-1 IgM secreting cells. The sensitivities of the two methods were statistically different (P<0.01). Conclusion Compared to ELISA, ELISPOT for detecting the anti-HSV-1 IgM secreting cells in cerehrospinal fluid is a more sensitive method for early diagnosing herpes simplex encephalitis.