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[使用硝酸纤维素膜上的微量斑点免疫酶测定法(斑点酶联免疫吸附测定法)诊断恰加斯病。I. 克氏锥虫两种抗原制剂的比较研究]

[Immunoenzyme assay using micro Dot on nitrocellulose (Dot-ELISA) in the diagnosis of Chagas' disease. I. Comparative study of 2 antigenic preparations of Trypanosoma cruzi].

作者信息

De Hubsch R M, Chiechie N, Comach G, Rangel Aldao R, Gusmao R D

机构信息

Departamento de Parasitología, Facultad Ciencias de la Salud, Universidad de Carabobo, Maracay, Venezuela.

出版信息

Mem Inst Oswaldo Cruz. 1988 Jul-Sep;83(3):277-85. doi: 10.1590/s0074-02761988000300003.

Abstract

Using the Dot-ELISA technique, two antigenic preparations of Trypanosoma cruzi epimastigote forms have been compared for the diagnosis of Chagas' disease: (1) The cytoplasmic fraction (cytoplasmic antigen) and (2) whole formalin fixed epimastigotes (integral antigen). There was been used sera from 95 chagasic patients with chronic cardiomyopathy, positive conventional serology and either positive or negative xenodiagnosis; 74 subjects with negative conventional serology, and either clinically normal or presenting cardiomyopathy; 74 patients with different diseases including syphilis, toxoplasmosis, leishmaniasis or autoantibodies such as rheumatoid factor and antinuclear antibodies. By defining the diagnostic titers (cut off): 1:512 for cytoplasmic antigen and 1:128 for the integral antigen, a sensitivity of 100% has been obtained with both antigenic preparations, being the specificity of 96% for the former and 100% for the latter when leishmaniasis sera were not included. A comparative study with conventional serology was carried out using 147 sera from a Laboratory of Chagas' diagnosis; Dot-ELISA with cytoplasmic antigen showed co-positivity index of 1.0, co-negativity 0.989 and efficiency of 0.993, and Dot-ELISA with integral antigen 1.0, 0.979 and 0.986 respectively. According to this evaluation, Dot-ELISA using whole formalin fixed epimastigotes might be a practical alternative for the serological diagnosis of Chagas' disease.

摘要

运用斑点酶联免疫吸附测定(Dot-ELISA)技术,对克氏锥虫上鞭毛体形式的两种抗原制剂进行了比较,以用于恰加斯病的诊断:(1)细胞质部分(细胞质抗原)和(2)经福尔马林固定的完整上鞭毛体(整体抗原)。研究使用了来自95例患有慢性心肌病的恰加斯病患者的血清,这些患者传统血清学检测呈阳性,异种诊断结果可为阳性或阴性;74例传统血清学检测呈阴性的受试者,这些受试者临床正常或患有心肌病;74例患有包括梅毒、弓形虫病、利什曼病等不同疾病或含有类风湿因子和抗核抗体等自身抗体的患者。通过确定诊断滴度(临界值):细胞质抗原为1:512,整体抗原为1:128,两种抗原制剂均获得了100%的灵敏度,当不包括利什曼病血清时,前者的特异性为96%,后者为100%。使用来自一个恰加斯病诊断实验室的147份血清与传统血清学进行了对比研究;使用细胞质抗原的Dot-ELISA显示共同阳性指数为1.0,共同阴性指数为0.989,效率为0.993,使用整体抗原的Dot-ELISA分别为1.0、0.979和0.986。根据该评估,使用经福尔马林固定的完整上鞭毛体进行Dot-ELISA可能是恰加斯病血清学诊断的一种实用替代方法。

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