弱智儿童弓形虫抗体检测的连续观察与分析

目的弓形虫感染与弱智儿童等神经系统发育迟钝儿童之间的关系,笔者在对市某社会福利院及本市某小学智力欠佳的儿童进行了弓形虫血清学的检测与分析的基础上,选择部分病例分别在治疗3个月和6个月后,采用乙酰螺旋霉素等药物治疗,用同样的方法检测弓形虫抗体进行对照性观察。方法选择弱智儿童18人在接受用乙酰螺旋霉素治疗后的3个月和6个月采用酶联免疫吸附试验(ELISA)和间接红细胞凝集试验(IHA)法进行弓形虫特异性Ab的检测。结果弱智儿童治疗组在治疗3个月和6个月以后的弓形虫抗体平均阳性检出率分别为16.67%,3/18(ELISA);11.11%,2/18(IHA)和5.56%,1/18,(ELISA)/5.56%,1/18,(IHA),低于弱智儿童未治疗组的平均阳性检出率(20.69%,6/29,ELISA;21.14%,7/29,IHA)。但高于正常对照组1.96%,1/51(ELISA);1.96%,1/51(IHA)。弱智儿童治疗6个月治疗组和弱智儿童未治疗组两组差异显著(X2=1.54,ELISA;X2=2.01,IHA。P<0.05)。结论儿童的弓形虫感染与其母亲在孕期或本人与动物的密切接触有关。因弓形虫能损害大脑和神经系统,严重影响儿童神经系统的发育和功能,成为优生优育的一大隐患。因此,防止母子间垂直传播和避免妇女(特别在孕期)与动物接触是预防儿童弓形虫感染的主要关键。提示临床上弱智儿童首先应及时进行弓形虫抗体的检测;其次应及时应用抗弓形虫的药物治疗。有利于弱智儿童智力的尽可能恢复。

Serial observation and analysis for the antibody detection in feeble intelligence children

In order to understand the relationship between Toxoplasma gondii infection and the detect of nervous system in feeble intelligence children,a part of this kind of children was chosen for study,and their specific toxoplasma antibodies were detected by means of ELISA and IHA assays 3 and 6 months after treatment with acethyspiramycin.It was demonstrated that the average positive detection rates of the specific toxoplasma antibodies in sera of 18 cases under treatment of 3 and 6 months were 16.67%(3/18) in ELISA and 11.11%(2/18) in IHA,and those of cases without treatment were 6.56%(1/18) both in ELISA and IHA;both of which were higher than those of the normal controls 1.96%(1/51) both in ELISA and IDA].The average positive detection rate of feeble intelligence children under treatment was obviously lower than that of cases without treatment.20.69%(6/29) in ELISA and 21.14%(7/29) in IHA] with a significant difference in statistics(X~(2)=1.54,2.01,P<0.05).From the observations in the present study,it is evident that the toxoplasmosis in children is closely associated with the Toxoplasma gondii infection of mothers during pregnancy or the close contact with animals of these children.Because toxoplasma can damage brain and interfere function and development of nervous system,therefore,the conventional examination of antibodies against toxoplasma in feeble intelligence children is necessary and the effective treatment for the toxoplasma infection is essential in the meantime.