Department of Infectious Diseases, Yahyanejad Hospital, Babol Medical University, Babol, 4717641367, Iran.
Int J Infect Dis. 2010 Mar;14(3):e250-3. doi: 10.1016/j.ijid.2009.05.008. Epub 2009 Aug 3.
The standard agglutination (SAT) and 2-mercaptoethanol (2-ME) tests are usually used in the follow-up of treated cases of human brucellosis. The purpose of this study was to monitor the levels of these tests, two years after clinical cure in cases of brucellosis.
From April 2003 to September 2008, 175 clinically cured cases of brucellosis (103 males, 72 females) were evaluated. Diagnosis of brucellosis was established with a SAT of > or =1:320 and a 2-ME of > or =1:80, with clinical symptoms and signs compatible with brucellosis. SAT and 2-ME were retested at the end of therapy and at 3-monthly intervals for two years. Serologic cure was considered in the event of a SAT titer decrease to < or =1:160 or a 2-ME decrease to<1:80.
The mean age of study patients was 31 +/- 13.5 years. At 6, 12, 18, and 24 months after treatment, SAT titers > or =1:320 were seen in 41 (23.4%), 22 (12.6%), 7 (4%), and 6 (3.4%) cases, respectively, whereas 2-ME titers > or =1:80 were seen in 51 (29.1%), 24 (13.7%), 12 (6.9%), and 8 (4.6%) cases, respectively. The probability of serologic cure for patients with SAT titers < or =1:640 was higher than for those >1:640 (95% confidence interval (CI) 2.5-3.47, p=0.023). The probability of serologic cure for patients with 2-ME titers < or =1:320 was higher than for those >1:320 (95% CI 2.48-3.5, p=0.04).
SAT and 2-ME may be found in significant titers in less than 5% of clinically treated cases after two years. Serologic cure for both tests with lower titers were higher than with higher titers.
标准凝集(SAT)和 2-巯基乙醇(2-ME)试验通常用于治疗人类布鲁氏菌病后的随访。本研究的目的是监测布鲁氏菌病临床治愈后两年内这些试验的水平。
2003 年 4 月至 2008 年 9 月,评估了 175 例临床治愈的布鲁氏菌病患者(男性 103 例,女性 72 例)。布鲁氏菌病的诊断采用 SAT≥1:320 和 2-ME≥1:80,同时伴有与布鲁氏菌病相符的临床症状和体征。在治疗结束时和随后的 3 个月内每月复查 SAT 和 2-ME,连续两年。SAT 滴度降至<或=1:160 或 2-ME 降至<1:80 时认为血清学治愈。
研究患者的平均年龄为 31±13.5 岁。治疗后 6、12、18 和 24 个月时,SAT 滴度≥1:320 的分别为 41 例(23.4%)、22 例(12.6%)、7 例(4%)和 6 例(3.4%),2-ME 滴度≥1:80 的分别为 51 例(29.1%)、24 例(13.7%)、12 例(6.9%)和 8 例(4.6%)。SAT 滴度<或=1:640 的患者血清学治愈率高于>1:640 的患者(95%置信区间 2.5-3.47,p=0.023)。2-ME 滴度<或=1:320 的患者血清学治愈率高于>1:320 的患者(95%置信区间 2.48-3.5,p=0.04)。
治疗两年后,不到 5%的临床治疗病例中仍可发现 SAT 和 2-ME 呈显著滴度。两种试验低滴度的血清学治愈率均高于高滴度。