论文部分内容阅读
目的评估几种常用血吸虫病诊断方法现场查病的效果。方法2005年11月,选取江西省鄱阳湖沿岸3个血吸虫病流行村的6～65岁居民为调查对象,用改良加藤厚涂片法(Kato-Katz法,3张涂片)和尼龙绢集卵孵化法进行病原学检测的同时,分别用胶体染料试纸条法(DDIA)、快速酶联免疫吸附试验(F-ELISA)及2种间接红细胞凝集试验(IHA-A和IHA-B)进行血清学检测,以评价该几种检测方法的效果。结果3村共检测居民1864人,平均粪检阳性率为9.7%。改良加藤法在血吸虫病中度、重度流行区的漏检率相对稳定,为20.0%～27.8%;尼龙绢集卵孵化法的漏检率在每克粪便虫卵数(EPG)>100时相对稳定(约25%)。DDIA、F-ELISA、IHA-A和IHA-B的平均阳性率分别为47.8%、50.0%、66.3%和40.1%。以病原学检测结果为金标准,DDIA、F-ELISA、IHA-A和IHA-B的敏感性分别为75.3%、65.8%、85.6%和76.0%;特异性为55.1%、51.7%、35.7%和63.6%。与其他几种免疫血清学诊断方法相比,IHA-B试剂的特异性、Youden指数、阳性似然比及粪检符合率最高。DDIA法与IHA-B法的符合率最高(77.3%),而F-ELISA和IHA-A的符合率最低(61.5%)。结论在血吸虫病中、重度流行区,改良加藤法虫卵检出率和稳定性均优于尼龙绢集卵孵化法;IHA-A的敏感性最高,IHA-B的4个指标最高,具有较高的现场使用价值,但需进一步提高其敏感性。
Objective To evaluate the effectiveness of several diagnostic methods for schistosomiasis prevalence on site. Methods In November 2005, residents of 6 ~ 65 years old in 3 endemic schistosomiasis villages along the Poyang Lake in Jiangxi Province were selected as subjects. The Kato-Katz method (3 smears) and nylon silk Egg hatching method was used for etiologic detection, and colloidal dye test strips (DDIA), rapid enzyme-linked immunosorbent assay (F-ELISA) and two kinds of indirect hemagglutination test (IHA-A and IHA-B) Serological tests to assess the effectiveness of several test methods. Results A total of 1864 inhabitants were detected in 3 villages, with an average positive rate of fecal examination of 9.7%. Modified Kato method in schistosomiasis moderate and severe endemic areas of the undetected rate was relatively stable, 20.0% -27.8%; nylon silk hatching method missed detection rate per gram of stool egg number (EPG)> 100 relative Stable (about 25%). The average positive rates of DDIA, F-ELISA, IHA-A and IHA-B were 47.8%, 50.0%, 66.3% and 40.1%, respectively. The sensitivity of DDIA, F-ELISA, IHA-A and IHA-B were 75.3%, 65.8%, 85.6% and 76.0%, respectively. The specificity was 55.1%, 51.7% and 35.7% And 63.6%. Compared with several other immune serological diagnostic methods, IHA-B reagent specificity, Youden index, positive likelihood ratio and fecal coincidence rate of the highest. The coincidence rate between DDIA and IHA-B was the highest (77.3%), while F-ELISA and IHA-A had the lowest coincidence rate (61.5%). Conclusions In schistosomiasis, the detection rate and stability of eggs in severe endemic areas and modified Kato law are better than that of nylon silk hatching method. The sensitivity of IHA-A is the highest, and IHA-B has the highest four indexes High on-site use value, but to further enhance its sensitivity.