包虫八项检查在骨包虫病诊断中的应用

目的 探讨包虫八项检查在骨包虫病诊断中的应用价值和骨包虫病的诊断策略.方法 对1999年10月至2008年9月因疑似骨包虫病而行包虫八项检查的36例患者进行回顾性研究.男19例,女17例;年龄10～67岁,平均35.9岁.采用金标渗滤法和酶联免疫法同时检测患者体内抗包虫囊液抗原(EsCF)、头节抗原(EgP)、囊液半纯化抗原B(EgB)、泡球蚴抗原(Em2)四个抗原的抗体水平,简称包虫八项检查.全部病例的最终诊断均经手术、病理学检查或穿刺活组织检查证实.对包虫八项检查结果进行ROC分析,确定最佳诊断界点(阈值),并计算灵敏度、特异度、Youden指数、阳性似然比、阴性似然比、阳性预报值、阴性预报值.结果 经病理学检查证实,36例患者中11例确诊为骨包虫病(胸椎包虫2例、肋骨包虫1例、腰椎包虫3例、骶骨包虫4例、髂骨包虫1例).包虫八项检查的灵敏度为90.91%,特异度为92.00%,Youden指数为0.8291,阳性似然比为11.3600,阴性似然比为0.0988,阳性预报值为83.33%,阴性预报值为95.83%.结论 血清学检查是骨包虫病鉴别诊断的重要手段.包虫八项检查诊断骨包虫病有较高的准确性.

Clinical application of the 8-test for immunodiagnosis of human bone cystic echinococcosis

Objective To investigate the clinical application value of the 8-test for immunodiagnosis of human bone cystic echinococcosis (BCE). Methods A retrospective study was made in 36 cases who were suspected to be BCE in our hospital from October 1999 to September 2008. The mean age was 35.9 years with a range of 10 to 67 years, and including 19 males, 17 females. All cases accepted the 8-test im-munodiagnosis and the final diagnosis were confirmed by operation or biopsy. The dot immunogold filtration assay (DIGFA) and enzyme linked immunosorbent assay (ELISA) were used to detect the antibodies to anti-gens of EgCF, EgP, EgB, and Em2 in patients at one time in our research, the name abbreviated to the 8-test for immunodiagnosis of human bone cystic echinococcosis. The sensitivity, specificity, Youden index, positive likelihood ratio, negative likelihood ratio, positive predictive value and negative predictive value of the 8-test immunodiagnosis were calculated and recorded. Results Be confirmed by pathology, 11 of these 36 cases were diagnosed as bone hydatidosis (including 2 cases with thoracic vertebrae, 1 case with rib, 3 cases with lumbar vertebrae, 4 cases with sacrum, and 1 case with illum). The sensitivity was 90.91%, the specificity was 92.00%, the Youden index was 0.8291, the positive likelihood ratio was 11.3600, the negative likelihood ratio was 0.0988, the positive predictive value was 83.33%, and the negative predictive value was 95.83%.Conclusion Serological examinations can be considered as diagnosis and initial differentiation for BCE, the 8-test immunodiagnosis has high accurate rate for diagnosing human BEC. It's helpful for identification of BCE.