[色标滴定酶免疫分析试验在人类布鲁氏菌病诊断中的评估]

[Evaluation of the Chromotitre EIA test in the diagnosis of human brucellosis].

作者信息

Colmenero J D, Porras J, Cárdenas A, Ocón P, Reguera J M, Delgado M, Sedeño J

机构信息

Unidad de Enfermedades Infecciosas, Hospital Regional, Málaga.

出版信息

Enferm Infecc Microbiol Clin. 1994 Feb;12(2):60-5.

PMID:7516713

Abstract

BACKGROUND

The aim of the study was to evaluate the diagnostic efficacy of Chromotitre EIA test for the diagnosis of human brucellosis and compare the same with other classical serologic test.

METHODS

A prospective study was performed in 50 patients with active brucellosis. Thirty blood donors, 64 patients with different neoplastic and autoimmune infectious processes, 20 patients with history of brucellosis and 8 subjects with continuous exposure to Brucella at work were analyzed as the control group.

RESULTS

Forty-five patients with brucellosis (90%) presented a positive IgM or IgG ELISA, 32 (62%) only IgM, 34 (68%) only IgG and 22 (44%) both immunoglobulins were positive. The sensitivity and specificity of ELISA test jointly evaluating IgM and IgG was 90 and 68%, respectively with these numbers being 62 and 98% and 68% and 38% for ELISA IgM and ELISA IgG. A moderate correlation was found between ELISA IgM with Bengal's Rose test (r = 0.53, p = 0.003) and sero-agglutination (r = 0.63, p = 0.0001) and ELISA IgG with the Coombs test (r = 0.55, p = 0.003). Only acceptable concordance was observed between ELISA IgM and sero-agglutination (kappa = 0.55, p = 0.0001).

CONCLUSIONS

The ELISA test evaluated was very useful for the detection of IgM antibodies but was found to be insufficient with respect to IgG antibodies. Despite the slight diagnostic efficacy of the ELISA IgG the combined parallel use of both immunoglobulins achieved a performance similar to that achieved with the classical tests.

摘要

背景

本研究的目的是评估Chromotitre酶免疫分析试验对人类布鲁氏菌病的诊断效能，并将其与其他经典血清学检测方法进行比较。

方法

对50例活动性布鲁氏菌病患者进行了一项前瞻性研究。将30名献血者、64例患有不同肿瘤和自身免疫性感染性疾病的患者、20例有布鲁氏菌病病史的患者以及8名在工作中持续接触布鲁氏菌的受试者作为对照组进行分析。

结果

45例布鲁氏菌病患者（90%）的IgM或IgG酶联免疫吸附测定（ELISA）呈阳性，32例（62%）仅IgM呈阳性，34例（68%）仅IgG呈阳性，22例（44%）两种免疫球蛋白均呈阳性。联合评估IgM和IgG时，ELISA试验的敏感性和特异性分别为90%和68%，ELISA IgM的敏感性和特异性分别为62%和98%，ELISA IgG的敏感性和特异性分别为68%和38%。ELISA IgM与孟加拉玫瑰红试验（r = 0.53，p = 0.003）和血清凝集试验（r = 0.63，p = 0.0001）之间存在中度相关性，ELISA IgG与抗人球蛋白试验（r = 0.55，p = 0.003）之间存在中度相关性。ELISA IgM与血清凝集试验之间仅观察到可接受的一致性（kappa = 0.55，p = 0.0001）。