Sýkora J, Pokorný J, Zástĕra M
Institut hygieny a epidemiologie, Praha.
Cas Lek Cesk. 1992 Mar 27;131(6):178-82.
In a group of 300 sera of subjects with clinically suspect nodular toxoplasmosis the authors tested by the IgM ELISA reaction in the reverse order the importance of the complement-fixation reaction for assessment of the acute stage of the infection. In view of the revealed prolonged detection of IgM antibodies the authors used quantitative evaluation of the reaction; they consider based on a probability pattern of antibody response coefficients of 10 and above important for differentiation of a recent infection. For the suggested method of evaluation it was confirmed that low CFR titres (1:8, 1:16, 1:32) imply usually (89.5%) latent infection, titres of 1:64 chronic (42.8%) and latent infection (57.2%); in no instance onset of the disease was involved. From the titre of 1:128 onwards there is a proportional increase of the probable detection of acute infections (titre 1:1024 as much as 72.7%. However, even high titres are not unequivocal evidence of recent infection. In view of the equivocal interpretation of results of the CFR the authors recommend for assessment of the acute stage of the nodular form of toxoplasmosis examination of the suspect subject by the CFR and in case of a medium or high level assessment of IgM by the ELISA method focused on the level and dynamics of the coefficient.
在一组300份临床疑似结节性弓形虫病患者的血清样本中，作者通过IgM ELISA反应，以相反顺序测试了补体结合反应在评估感染急性期方面的重要性。鉴于所发现的IgM抗体检测时间延长，作者采用了反应的定量评估方法；他们认为，基于抗体反应系数为10及以上的概率模式，对于区分近期感染很重要。对于所建议的评估方法，已证实补体结合反应（CFR）低滴度（1:8、1:16、1:32）通常（89.5%）意味着潜伏感染，1:64滴度意味着慢性感染（42.8%）和潜伏感染（57.2%）；在任何情况下都不涉及疾病发作。从1:128滴度起，急性感染的可能检出率成比例增加（1:1024滴度时高达72.7%）。然而，即使是高滴度也并非近期感染的确切证据。鉴于CFR结果的解释存在不确定性，作者建议，为评估结节性弓形虫病急性期，对疑似患者进行CFR检测，若ELISA法检测IgM处于中等或高水平，则重点关注系数的水平和动态变化。
