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目的 研究小儿包虫病的免疫诊断方法 ,探索其抗体应答阴性反应原因。方法 采用间接ELISA和单克隆双抗体夹心ELISA方法 ,对 1998年 5月至 2 0 0 2年 5月新疆自治区人民医院普外科 5 5例小儿包虫病患儿血清的IgG及亚类IgG1、IgG2 、IgG3 、IgG4和IgA、IgM、IgE类抗体及抗原和循环免疫复合物 (CIC)进行检测。 结果 8种抗体检查方法中IgG1亚型抗体检测的敏感性和特异性最好 ;15例IgG抗体阴性患儿中 ,有 12例分别检测出IgG亚类和 (或 )IgM、IgA、IgE ,有 3例患儿血清各种抗体均呈阴性反应 ;患儿IgM抗体阳性率高于成人 ;IgG1分别与其它种抗体联合检测 ,以IgG1+IgA +IgM检出率最高 ;IgG阴性小儿患者血清的循环抗原和CIC阳性率分别为 4 0 %及 2 6 6 7%。结论 IgG1+IgA +IgM抗体联合检测方法可提高小儿包虫病免疫诊断的敏感性。抗包虫总IgG抗体表达水平低下、抗体表达种类不同及CIC的形成 ,是造成包虫病患儿IgG抗体反应阴性的主要原因
Objective To study the immunodiagnosis of pediatric echinococcosis and to explore the reason of its negative response to antibody. Methods The indirect immunosorbent assay (ELISA) and monoclonal antibody sandwich ELISA (ELISA) were used to detect the IgG and IgG1, IgG2 and IgG2 in serum of 55 children with pediatric echinococcosis from May 1998 to May 2002 in People’s Hospital of Xinjiang Uygur Autonomous Region. , IgG3, IgG4 and IgA, IgM, IgE antibodies and antigens and circulating immune complexes (CIC) were detected. Results The sensitivity and specificity of the IgG1 subtype antibodies in the eight antibody test methods were the best. Among the 15 IgG-negative children, 12 were detected IgG subclasses and / or IgM, IgA, IgE, Serum antibodies of all 3 cases were negative. The positive rate of IgM antibody in children was higher than that in adults. The IgG1 + IgG + IgA + The positive rates of antigen and CIC were 40% and 2667% respectively. Conclusions The combined detection of IgG1 + IgA + IgM antibodies can improve the immunological diagnosis of echinococcosis in children. Anti-hydatid total IgG antibody expression is low, the different types of antibody expression and the formation of CIC, which is caused by hydatid disease in children with IgG antibody-negative main reason