Zeid A M, Hassan M M, Attia W M, el-Desouky A I, Badawy A M, Aly A S
Department of Pediatrics, Faculty of Medicine, Zagazig University, Egypt.
J Egypt Soc Parasitol. 1994 Aug;24(2):371-82.
Hepatitis-B surface antigen (HBsAg), circulating anti-schistosomal IgG (CSAb) and circulating specific schistosomal immune complexes (CIC) were detected, using ELISA, in sera of 40 active nephrotic children, 40 active S. mansoni infected cases and 20 apparently normal age-matched controls. The presence of HBsAg cases was significantly higher among nephrotic cases (20%), active S. mansoni cases (17.5%) than controls. Moreover, HBsAg cases were significantly higher in positive CIC S. mansoni cases than negative CIC ones. The mean O.D. readings of CSAb was significantly higher in positive HBsAg nephrotic cases than negatives. At the same time, the anti-schistosomal antibodies were higher in S. mansoni cases with proteinuria than those without. Specific CIC level was significantly higher among nephrotic and schistosomiasis cases than controls. The CIC were significantly higher in schistosomiasis cases with positive HBsAg than those with negative HBsAg and were detected in 80% of cases with proteinuria compared to 37% of cases without proteinuria with a statistically significant difference. On the other hand, CIC level was not influenced, in nephrotic cases, by the presence or absence of HBsAg. It was concluded that the presence of proteinuria was considered as a good monitor of the kidney affection either with schistosomiasis or the nephrotic syndrome or the HBsAg. The detection of CIC can be used as a good monitor too and could be included in methods of early diagnosis and/or following the disease prognosis.
采用酶联免疫吸附测定法(ELISA)检测了40例活动性肾病患儿、40例曼氏血吸虫感染活动期患者以及20例年龄匹配的明显正常对照者血清中的乙肝表面抗原(HBsAg)、循环抗血吸虫IgG(CSAb)和循环特异性血吸虫免疫复合物(CIC)。肾病患者(20%)和曼氏血吸虫感染活动期患者(17.5%)中HBsAg阳性病例的比例显著高于对照组。此外,曼氏血吸虫病CIC阳性病例中的HBsAg阳性病例显著多于CIC阴性病例。HBsAg阳性的肾病患者中CSAb的平均光密度读数显著高于阴性患者。同时,有蛋白尿的曼氏血吸虫病患者的抗血吸虫抗体高于无蛋白尿患者。肾病和血吸虫病患者中特异性CIC水平显著高于对照组。曼氏血吸虫病患者中HBsAg阳性者的CIC显著高于HBsAg阴性者,80%有蛋白尿的病例检测到CIC,而无蛋白尿病例中这一比例为37%,差异有统计学意义。另一方面,在肾病患者中,CIC水平不受HBsAg存在与否的影响。得出的结论是,蛋白尿的存在被认为是血吸虫病、肾病综合征或HBsAg所致肾脏病变的良好监测指标。CIC的检测也可作为良好的监测指标,并可纳入疾病早期诊断和/或随访疾病预后的方法中。