Joller-Jemelka H I, Vogt M, Joller P W
Schweiz Med Wochenschr. 1985 Jan 26;115(4):125-32.
Since AIDS-specific laboratory tests are not yet commercially available, laboratory diagnoses of AIDS or of the AIDS-related complex (ARC) are based on "surrogate markers". While single tests are of limited diagnostic value, test combinations are of greater help. However, these tests should be applied restrictively and stepwise. The following parameters were analyzed in respect of their diagnostic and differential-diagnostic value: absolute number of lymphocytes, delayed type hypersensitivity skin tests to seven recall antigens, beta-2-microglobulin, serum-neopterin, C-reactive protein, complement factor B, circulating immune complexes, immunoglobulins, hepatitis B markers, and the ratio of T helper to T suppressor cells. 14 AIDS patients, 11 ARC patients, 23 healthy homosexuals, 6 iv drug users, 6 hemophiliacs and 35 patients with various other disorders were investigated. To analyse the value of a given test or of test combinations in the diagnosis of AIDS and ARC, a discrimination index was introduced and defined as the difference between the percentage of pathological values in one patient group compared to the percentage of pathological values in the other group. A discrimination index of 100 means that a given test is pathologic in all members of one group and negative in all members of the other group. A discrimination index of 60 may mean 80% of pathological values in one group versus 20% in the other. To distinguish AIDS patients from ARC patients the test combination yielding the highest mean discrimination index included serum neopterin, complement factor B and C-reactive protein.(ABSTRACT TRUNCATED AT 250 WORDS)
由于尚无针对艾滋病的商业化实验室检测方法,艾滋病或艾滋病相关综合征(ARC)的实验室诊断基于“替代标志物”。虽然单项检测的诊断价值有限,但检测组合则更有帮助。然而,这些检测应谨慎且逐步应用。分析了以下参数的诊断和鉴别诊断价值:淋巴细胞绝对计数、针对七种回忆抗原的迟发型超敏皮肤试验、β2-微球蛋白、血清新蝶呤、C反应蛋白、补体因子B、循环免疫复合物、免疫球蛋白、乙肝标志物以及辅助性T细胞与抑制性T细胞的比例。对14例艾滋病患者、11例ARC患者、23名健康同性恋者、6名静脉吸毒者、6名血友病患者以及35例患有其他各种疾病的患者进行了研究。为分析特定检测或检测组合在艾滋病和ARC诊断中的价值,引入了鉴别指数,定义为一组患者中病理值百分比与另一组患者中病理值百分比的差值。鉴别指数为100意味着特定检测在一组所有成员中呈病理状态,而在另一组所有成员中呈阴性。鉴别指数为60可能意味着一组中80%的病理值与另一组中20%的病理值。为区分艾滋病患者与ARC患者,产生最高平均鉴别指数的检测组合包括血清新蝶呤、补体因子B和C反应蛋白。(摘要截选至250词)