Kimirilova O G, Kharchenko G A
Astrakhan State Medical University, 414000, Astrakhan, Russia.
Klin Lab Diagn. 2019;64(6):376-379. doi: 10.18821/0869-2084-2019-64-6-376-379.
Giardiasis in children remains an urgent problem, the importance of which is determined by the endemicity for many countries and regions, polymorphism of the clinic, which causes difficulties in clinical diagnosis of this pathology. The report presents the results of the diagnostic significance of methods of laboratory diagnostics giardiase: microscopy of native and stained with Lugol solution preparation fecal enzyme-linked immunoassay (ELISA) for the presence of antibodies of class IgM and IgG antibodies to the antigens of Giardia in the serum and antigen of G. Lamblia in feces, polymerase chain reaction (PCR) - detection of Giardia DNA in feces obtained during the examination of 160 patients with giardiasis children aged 3 to 14 years. The results of our study suggest that the most informative methods of diagnosis of giardiasis in children is coproscopy (specificity - 96.2%, sensitivity - 98.1%), PCR coprofiltrate. (specificity - 85%, sensitivity 82.5%), determination of antigen in feces by ELISA (specificity - 87,5%, sensitivity - 60%). With high specificity of the blood ELISA method (90%), the sensitivity of the method is only 27.5%. It should be recognized that the «gold standard» diagnosis of giardiasis remains microscopy of native and stained with a solution of Lugol preparation of feces with a three - time study at intervals of 2-3 days.
儿童贾第虫病仍然是一个紧迫的问题,许多国家和地区的地方流行性以及临床症状的多样性决定了其重要性,这给该疾病的临床诊断带来了困难。本报告展示了贾第虫病实验室诊断方法的诊断意义结果:对160名3至14岁患贾第虫病儿童检查期间所获粪便进行直接镜检和用卢戈氏液染色镜检、检测血清中针对贾第虫抗原的IgM类和IgG类抗体以及粪便中蓝氏贾第鞭毛虫抗原的酶联免疫吸附测定(ELISA)、聚合酶链反应(PCR)——检测粪便中的贾第虫DNA。我们的研究结果表明,儿童贾第虫病最具信息价值的诊断方法是粪便检查(特异性——96.2%,敏感性——98.1%)、PCR粪便滤液检查(特异性——85%,敏感性82.5%)、通过ELISA测定粪便中的抗原(特异性——87.5%,敏感性——60%)。血液ELISA方法虽特异性高(90%),但其敏感性仅为27.5%。应该认识到,贾第虫病的“金标准”诊断仍然是对粪便直接镜检并用卢戈氏液染色镜检,间隔2至3天进行三次检查。