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探讨肾综合征出血热早期诊断方法。方法 :用macELISA、IFAT两种方法同时检测经临床诊断肾综合征出血热病人血清 40份 ,非出血热血清 2 0份 ,正常人血清 2 0份 ,并进行对比研究。而且阳性血清用 2 -巯基乙醇破坏IgM试验 ,阴性血清加类风湿因子阳性血清进行干扰试验。结果 :用macELISA法检测肾综合征出血热病人病程第 2天即可出现阳性 ,第 3～ 4天特异性抗体IgM阳性率达 89% ;第 5～ 7天可达 10 0 % ,而IFAT法同病日抗体阳性率只有 5 5 %与 70 % (P <0 .0 5 )。非出血热病人与正常人特异性抗体全部阴性。阳性血清用 2 -巯基乙醇破坏IgM后macELISA检测为阴性 ;而阴性血清加类风湿阳性血清后再用本法检测无假阳性。结论 :与IFAT法相比 ,macELISA法诊断肾综合征出血热特异性强 ,灵敏度高 ,早期诊断意义大。
To investigate the early diagnosis of hemorrhagic fever with renal syndrome. Methods: Forty serum samples from patients with hemorrhagic fever with renal syndrome were detected simultaneously by macELISA and IFAT. 20 non-haemorrhagic fever sera and 20 normal individuals were compared and analyzed. And positive serum with 2 - mercaptoethanol destroyed IgM test, negative serum plus rheumatoid factor positive serum interference test. Results: The macroscopic examination of hemorrhagic fever with renal syndrome could be positive on the second day. The positive rate of IgM was 89% on days 3 to 4, 100% on day 5 to 7, The positive rate of antibody on the same day was only 55% and 70% (P <0.05). Non-hemorrhagic fever patients and normal all the specific antibodies. Positive serum with 2 - mercaptoethanol after the destruction of IgM macELISA test was negative; and negative serum plus rheumatoid positive serum and then detected by this method no false positive. Conclusion: Compared with the IFAT method, macELISA method is more specific and sensitive in the diagnosis of hemorrhagic fever with renal syndrome. Early diagnosis is of great significance.