Nuzum E, White F, Thakur C, Dietze R, Wages J, Grogl M, Berman J
Division of Experimental Therapeutics, Walter Reed Army Institute of Research, Washington, DC 20307-5100.
J Infect Dis. 1995 Mar;171(3):751-4. doi: 10.1093/infdis/171.3.751.
To diagnose symptomatic visceral leishmaniasis (kala-azar) using peripheral blood rather than tissue aspirates, a polymerase chain reaction (PCR) technique was developed for which the detection limit is 1 Leishmania-infected macrophage in 8 mL of blood. For Indian, Kenyan, or Brazilian patients with parasitologically confirmed kala-azar, 57 of 63 cases before treatment had blood that was PCR-positive (90% sensitivity). None of 40 clinically healthy persons had PCR-positive blood (100% specificity). Twelve (92%) of 13 clinically cured Indian patients had negative PCR reactions 1-6 months after treatment. This PCR procedure can provide a parasitologic diagnosis for the vast majority of kala-azar cases before therapy, may identify patients who have been successfully treated by chemotherapy, and should substantially reduce the need for invasive tests.
为了使用外周血而非组织抽吸物来诊断有症状的内脏利什曼病（黑热病），开发了一种聚合酶链反应（PCR）技术，其检测限为每8毫升血液中有1个利什曼原虫感染的巨噬细胞。对于经寄生虫学确诊为黑热病的印度、肯尼亚或巴西患者，63例治疗前患者中有57例血液PCR呈阳性（敏感性为90%）。40名临床健康者中无一例血液PCR呈阳性（特异性为100%）。13例临床治愈的印度患者中有12例（92%）在治疗后1 - 6个月PCR反应呈阴性。这种PCR方法可为绝大多数黑热病患者在治疗前提供寄生虫学诊断，可识别经化疗成功治疗的患者，并应大幅减少侵入性检测的需求。
