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目的比较粪检与免疫诊断方法检测血吸虫感染的效果。方法在云南省大山区峡谷型血吸虫病流行区选择508例村民作为检查对象,收集病史个案,以尼龙绢集卵孵化法和改良Kato-Katz法进行病原学检查,再同时以胶体染料试纸条法(DDIA)、酶联免疫吸附试验(ELISA)和环卵沉淀试验(COPT)进行抗血吸虫抗体检测,将检测结果进行比较分析。结果Kato-Katz法查出阳性病人120例,其中25例孵化法为阴性;孵化法查出阳性病人163例,其中68例Kato-Katz法为阴性。DDIA、ELISA和COPT与孵化法的阳性符合率分别为95.1%、98.2%和82.8%,与Kato-Katz法的阳性符合率分别为92.5%、96.0%和84.0%。结论粪检方法尤其是Kato-Katz法漏检率较高,以其作为评价免疫诊断方法的标准似不合适。DDIA和ELISA与孵化法和Kato-Katz法的阳性符合率均较高,敏感性明显高于粪检法,而且操作方便,适用于现场筛查化疗目标人群。
Objective To compare the results of fecal sequestration and immunodiagnosis in detecting schistosomiasis infection. Methods A total of 508 villagers were enrolled in the endemic schistosomiasis endemic area in Dashan District, Yunnan Province. 508 cases of villagers were selected as the object of investigation. Case histories were collected and tested for pathogenicity by nylon silk hatching method and modified Kato-Katz method. At the same time, (DDIA), enzyme-linked immunosorbent assay (ELISA) and egg ring precipitation test (COPT) were used to detect anti-schistosome antibody, and the results were compared and analyzed. RESULTS: Kato-Katz method was used to detect 120 cases of positive patients, of which 25 cases were negative for hatching method. 163 cases were found positive by hatching method, of which 68 cases were negative by Kato-Katz method. The positive coincidence rates of DDIA, ELISA, and COPT with hatching method were 95.1%, 98.2% and 82.8%, respectively. The positive coincidence rates with DDT, ELISA and Kato-Katz were 92.5%, 96.0% and 84.0%, respectively. Conclusions Fecal sequestration methods, especially the Kato-Katz method, have a high probability of missed detection, which may not be suitable as a standard for the evaluation of immunodiagnostic methods. The positive coincidence rates of DDIA and ELISA with hatching and Kato-Katz methods were higher, the sensitivity was significantly higher than the fecal semen method, and easy to operate, suitable for on-site screening of chemotherapy target population.