Banatvala J E, Best J M, Bertrand J, Bowern N A, Hudson S M
Br Med J. 1970 Aug 1;3(5717):247-50. doi: 10.1136/bmj.3.5717.247.
In 45 patients with rubella-like illnesses during pregnancy serological tests showed that the clinical diagnosis had been accurate in only 20. Since only 16 of these patients had presented for laboratory investigations within a week of the onset of symptoms, the value of haemagglutination-inhibition tests was considerably reduced; the diagnosis in these cases was confirmed by complement-fixation and rubella-specific IgM tests.Of 172 patients exposed to a rubella-like illness, only 17 were seronegative; 105 sought advice within two weeks of exposure, and therefore the haemagglutination-inhibition antibody tests were useful in determining immunity. Since the clinical diagnosis of rubella was proved incorrect in a number of cases, these pregnancies were saved. Hence both doctors and patients should report both exposure to and rubella-like illnesses as early as possible, so that laboratory investigations may be carried out without delay.
在45例孕期患风疹样疾病的患者中,血清学检测表明,临床诊断仅在20例中是准确的。由于这些患者中只有16例在症状出现后一周内进行了实验室检查,血凝抑制试验的价值大大降低;这些病例的诊断通过补体结合试验和风疹特异性IgM试验得以证实。在172例接触过风疹样疾病的患者中,只有17例血清学阴性;105例在接触后两周内寻求建议,因此血凝抑制抗体试验有助于确定免疫状态。由于在一些病例中已证明风疹的临床诊断有误,这些妊娠得以挽救。因此,医生和患者都应尽早报告接触史和风疹样疾病,以便及时进行实验室检查。