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目的用细粒棘球蚴囊液抗原检测甘肃省环县地区细粒棘球蚴病患者血清中特异性Ig G及其亚型抗体。方法采集甘肃省环县地区经B超确诊的37例细粒棘球蚴病患者和29例健康人血清,ELISA法检测血清中抗棘球蚴囊液抗原的特异性Ig G抗体及其亚型Ig G1、Ig G2和Ig G4。应用Med Calc软件,以B超检测结果为金标准,根据ELISA结果绘制受试者工作特征(ROC)曲线,通过曲线下面积的配对z检验,比较这4种抗体的诊断性能差异,确定最佳诊断阈值。用卡方检验分析并比较棘球蚴囊液抗原用于检测4种抗体的灵敏性和特异性。结果用囊液抗原检测Ig G、Ig G1、Ig G2和Ig G4抗体的ROC曲线下面积分别为0.722、0.919、0.712和0.835,其中Ig G1的曲线下面积显著大于Ig G和Ig G2的面积(P<0.05)。棘球蚴囊液抗原检测这4种抗体的灵敏性分别为54.1%、91.9%、67.6%和75.7%,其中Ig G1的灵敏性高于Ig G、Ig G2和Ig G4(P<0.05);特异性分别为89.7%、82.8%、72.4%和89.7%,Ig G1的特异性与Ig G、Ig G2和Ig G4相比,差异无统计学意义(P>0.05)。检测Ig G4抗体在CEⅠ-Ⅲ型病例中的灵敏性高于CEⅣ-Ⅴ型病例(P<0.05)。结论棘球蚴囊液抗原检测血清中Ig G1抗体的灵敏性优于其他3种抗体,但特异性与其他3种抗体间差异无统计学意义。
Objective To detect the specific Ig G and its subtype antibodies in patients with Echinococcus granulosus in Huan County, Gansu Province, using Echinococcus granulosus antigen as antigen. Methods Thirty-seven patients with Echinococcosis and 29 healthy individuals diagnosed by B ultrasound were collected from Huanxian district, Gansu province. Serum anti-Echinococcus antibodies and their subtypes Ig G1, Ig G2 and Ig G4. Med Calc software was used to test the BOC results as the gold standard. The receiver operating characteristic (ROC) curves were plotted based on the ELISA results. The differences of the diagnostic performance of the four antibodies were compared to determine the best Diagnostic threshold. The chi square test was used to analyze and compare the hydatid cyst fluid antigen used to detect the sensitivity and specificity of the four antibodies. Results The area under the ROC curve of IgG, Ig G1, Ig G2 and Ig G4 antibodies detected by cystic fluid antigen were 0.722, 0.919, 0.712 and 0.835, respectively. The area under the curve of Ig G1 was significantly larger than that of Ig G and Ig G2 P <0.05). The sensitivity of detection of hydatid cyst fluid antigen was 54.1%, 91.9%, 67.6% and 75.7%, respectively. The sensitivity of Ig G1 was higher than that of Ig G, Ig G2 and Ig G4 (P <0.05). The specificity of Ig G1 was 89.7%, 82.8%, 72.4% and 89.7% respectively. The specificity of Ig G1 was not significantly different from those of Ig G, Ig G2 and Ig G4 (P> 0.05). The sensitivity of detecting Ig G4 antibody in CEⅠ-Ⅲ cases was higher than that in CEⅣ -Ⅴ cases (P <0.05). Conclusion The sensitivity of serum Ig G1 antibody in detection of hydatid cyst fluid antigen is superior to the other three antibodies, but there is no significant difference between specificity and other three antibodies.