国内国外黑热病检测实验方法对比结论

国内黑热病的诊断方法

间接荧光抗体试验(IFAT)、酶联免疫吸附试验(ELISA)、直接凝集试验(DAT)、间接血球凝集试验(IHA)、对流免疫电泳(CIE)、重组抗原(rK39)试纸条、酶联免疫印渍技术等。

国内外一致认为IFAT是诊断黑热病较敏感的一种方法，李国茹等用IFAT共检查l9例病人，其中l0例骨位穿刺确诊的现症病人均为阳性(1：160～1：10 240)，5例疑似病人亦阳性(1：4～1：5 120)，经锑剂治疗后痊愈，说明IFAT 可较早发现病人，能及时和准确地反映疫区人群中黑热病的流行现状。

而ELISA则是一种比较快速的检测方法，王秀珍等建立的快速ELISA法，对37例临床症状疑似黑热病者，同时作骨滋穿刺和耳垂采血作快速ELISA，二者阳性符合率100%，其中3例骨穿阴性，快速ELISA阳性的病人，经再次作骨穿和复查原骨翻片均查见利杜体。这不仅为有临床症状而骨穿阴性者提供较可靠的辅助诊断．而且可用于现场进行传染源监测和流行病学调查。

为了检测更加方便，一些学者研发了试纸条。2005年李国茹等通过rK39试纸条与病原学两种诊断黑热病方法的比较，判断rK39试纸条检测黑热病的可靠性，结果显示应用rK39试纸条诊断黑热病现症患者的阳性检出率可达96.07% ，与病原学方法相比，检出率明显提高(P<0．01)。

利用IFAT和ELISA方法检测具有较高的临床价值，但这两种方法常和某些疾病存在交叉反应，故使用上有一定的局限性。鲍勇等利用免疫印渍技术分析杜氏利什曼前鞭毛体蛋白分子量，并用其蛋白带分别和黑热病人血清及其他血清进行酶联免疫印渍试验，结果显示63ku的特异性和灵敏度都非常高，仅和麻风病人有轻度交叉反应，这证明63ku是杜氏利什曼前鞭毛体特异性抗原，该诊断方法较简单，结果较可靠，和麻风病人的轻度交叉反应易从临床上予以区别。有学者认为39ku也是杜氏利什曼前鞭毛体特异性抗原，胡孝素等对健康人、非黑热病病人和11例确诊黑热病病人的血清进行不同程度的稀释，并将表达杜氏利什曼原虫39ku抗原的大肠埃希菌稀释到达1：400时，全部黑热病患者的血清均能识别重组杜氏利什曼原虫39ku抗原，具有临床诊断价值 。

国外黑热病的诊断方法

Urine sample direct agglutination test, precipitation-free test, distilled water test, aldehyde test, urethane test, brake test, etc. 2. The previous methods for diagnosing kala-azar are serum direct agglutination test and urine sample enzyme - linked immunosorbent assay.

In the study of Islain M Z in the UK, the sensitivity was 91.0%, 93.3%, and the EI ISA specificity was 97.3%. Islam MZ and the Department of Parasitology, Aichi Medical University, Japan, and several other universities have jointly developed a new direct agglutination test using urine samples as samples. The results show that there is no significant difference in the specificity of ELISA and urine agglutination tests. Because this method is superior to the previous serum direct agglutination test and urine sample enzyme-linked immunosorbent assay, it has many advantages such as simple and non-invasive detection conditions, and the instrument and equipment required for ELISA are omitted. It is very important for the diagnosis of kala-azar, especially in the field.

Another method commonly used to detect kala-azar is immunoprecipitation. French scholars have widely used human and canine surveys in the Mediterranean coastal areas where black fever is common. According to their research, the positive rate of precipitation reaction is 64% to 95% in cases diagnosed as kala-azar. The aldosterone test is also a simple and rapid method for diagnosing kala-azar. The method is to add 1 drop of acetaldehyde formalin to the patient's 1 mL serum, and the white gel appears in a few minutes as a positive reaction. The positive reaction disappears after the disease is cured, and the cause of the disappearance is closely related to the decrease of the globulin titer. This test is non-specific or weakly specific, because high-gamma globulin anemia caused by other causes is also often positive, so it is not recommended to use this method to diagnose kala-azar.

Some people in foreign countries have also applied the brake test to detect kala-azar. Some scholars have reported that brake antibodies are contained in the serum of cutaneous leishman patients. However, this report is questionable because a complement was added to their trial, and a component of this complement is likely to be a thermal instability in the normal serum that prevents the Leishmania promastigotus from moving. factor. Therefore, this kind of experiment has not been widely used at present.

检测黑热病的试剂盒推荐

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