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目的 探讨A组 β溶血性链球菌 (乙链菌 )脂磷壁酸 (LTA)抗体在风湿热诊断中的意义。方法 用从A组乙链菌中提取的LTA作为抗原 ,采用斑点酶联免疫吸附测定 (ELISA)法检测血清中的LTA抗体。结果 ①风湿性心脏炎组LTA IgG抗体滴度水平高于静止期风湿性心脏病组、病毒性心肌炎组、非风湿性心脏瓣膜病组、其他关节炎组的滴度水平 ;②活动期风湿热患者LTA IgG抗体阳性率 (6 4 % )高于对照组的阳性率 ;③风湿性心脏炎患者的LTA IgG抗体阳性率与外周血淋巴细胞促凝血活性 (PCA)、抗链球菌壁多糖抗体 (ASP)、抗DNAse B、血沉、C反应蛋白的阳性率相接近 ,高于抗链球菌溶血素O (ASO)的阳性率。结论 血清LTA抗体在判断风湿热和风湿性心脏病风湿活动有较高的敏感性和一定的特异性
Objective To investigate the significance of group A streptococcal lipoteichoic acid (LTA) antibody in the diagnosis of rheumatic fever. Methods LTA extracted from group A streptozotocin was used as antigen, and the serum LTA antibody was detected by the enzyme-linked immunosorbent assay (ELISA). Results ① The titer of LTA IgG in patients with rheumatic carditis was significantly higher than that in patients with quiescent rheumatic heart disease, viral myocarditis, non-rheumatic heart valvular disease and other arthritis groups. ② The activity of rheumatic fever The positive rate of LTA IgG antibody in patients (64%) was higher than that in the control group. (3) The positive rate of LTA IgG antibody in patients with rheumatic carditis was significantly correlated with the peripheral blood lymphocyte procoagulant activity (PCA), anti-streptococcal wall polysaccharide antibody ASP), anti-DNAse B, erythrocyte sedimentation rate and C-reactive protein were higher than the positive rate of anti-streptolysin O (ASO). Conclusion Serum LTA antibody has high sensitivity and certain specificity in judging the rheumatic activity of rheumatic fever and rheumatic heart disease