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用于布鲁氏菌病诊断的不同血清学检测方法的比较研究(作者译)

[Comparative study of different serological tests for the diagnosis of brucellosis (author's transl)].

作者信息

Daza R M, Damaso D, Moreno M

出版信息

Med Clin (Barc). 1981 Jan 25;76(2):57-60.

PMID:7012471
Abstract

The diagnosis of brucellosis is frequently a difficult one, and it is founded basically on the results of blood cultures and serological tests. Wright's classical agglutination test is commonly utilized in the serological diagnosis of brucellosis and its value is well established in the acute forms of the disease; for the diagnosis of subacute or chronic forms, however, a Coombs test must be performed to show incomplete antibodies. The agglutination carried out with serum treated with 2-mercaptoethanol allows the determination of the type of immunoglobulins present. Indirect immunofluorescence has been infrequently utilized in the diagnosis of brucellosis. The first three tests have been compared with indirect immunofluorescence using sera from 100 patients presenting with fever of unknown origin. All tests were negative in 40 sera, and of the 60 remaining sera only 32 were positive to all four tests. The highest titers were found with the Coombs test, while immunofluorescence yielded titers which were never above 1/320. Significant correlation coefficients were obtained between the tests. The best correlation was obtained between immunofluorescence and 2-mercaptoethanol, followed by immunofluorescence and Coombs, and by immunofluorescence and agglutination. Only immunofluorescence titers above 1/80 corresponded to the same of superior titers in the remaining tests; thus immunofluorescence titers below 1/80 can not be considered as diagnostic of the disease. The authors believe that immunofluorescence to 1/80 can be utilized as a quick routine test for the diagnosis of brucellosis, its disadvantages being a high cost and the requirement for an immunofluorescence microscope which may not be available in many laboratories.

摘要

布鲁氏菌病的诊断常常颇具难度,其诊断基本依据血培养和血清学检测结果。赖特经典凝集试验常用于布鲁氏菌病的血清学诊断,其在该病急性形式中的价值已得到充分确立;然而,对于亚急性或慢性形式的诊断,必须进行抗人球蛋白试验以检测不完全抗体。用2-巯基乙醇处理血清后进行的凝集试验可确定存在的免疫球蛋白类型。间接免疫荧光法在布鲁氏菌病诊断中的应用并不常见。已将前三项检测与间接免疫荧光法进行比较,所用血清来自100例不明原因发热患者。40份血清的所有检测均为阴性,在其余60份血清中,只有32份对所有四项检测均呈阳性。抗人球蛋白试验的滴度最高,而免疫荧光法产生的滴度从未超过1/320。各项检测之间获得了显著的相关系数。免疫荧光法与2-巯基乙醇之间的相关性最佳,其次是免疫荧光法与抗人球蛋白试验,以及免疫荧光法与凝集试验。只有免疫荧光滴度高于1/80才与其余检测中相同或更高的滴度相对应;因此,免疫荧光滴度低于1/80不能被视为该病的诊断依据。作者认为,免疫荧光滴度达到1/80可作为布鲁氏菌病诊断的快速常规检测方法,其缺点是成本高且需要免疫荧光显微镜,而许多实验室可能没有这种设备。

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