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[评估用于检测人类自然感染中肺炎支原体抗原引起的肱骨反应的传统和新一代检测方法。II. 呼吸道感染患者中支原体抗体的出现情况和水平]

[Evaluation of conventional and new generation tests for testing the humeral response to Mycoplasma pneumoniae antigens in natural infections in humans. II. Occurrence and level of mycoplasma antibodies in patients with respiratory tract infections].

作者信息

Rastawicki W

机构信息

Zakład Bakteriologii PZH w Warszawie.

出版信息

Med Dosw Mikrobiol. 1995;47(1-2):55-76.

PMID:8523971
Abstract

The aim of the study was to observe the frequency of occurrence of mycoplasmal antibodies detected by the complement fixation test (CFT), immunoelectroprecipitation test (IEPT) and ELISA in selected groups of patients with respiratory tract infections and to determine the dependence of these antibodies on the age of patients and length of illness. 521 serum samples collected from 404 persons were examined; 378 samples were obtained from 276 patients with pneumonia and 143 from 128 patients with upper respiratory tract infections. Additionally, serum samples from 50 patients with B. pertussis were investigated in this section of the study as a control test to demonstrate the specificity of the tests. It was established that in patients with pneumonia mycoplasmal antibodies are, as a rule, detected in much higher titers than in patients with upper respiratory tract infections. On with age, the level of mycoplasmal antibodies detected in all the three tests rose in the examined patients. In the highest titers antibodies against M. pneumoniae were detected in adults within the age 21-50. As a rule mycoplasmal IgM antibodies reached a level 2-3 times higher than IgG antibodies. It was also shown that already during the first week of illness antibodies against M. pneumoniae determined by the CFT, IEPT and ELISA in the sera of the examined persons are higher than the level known to be diagnostically significant. During the second week of illness IgA and IgM antibodies have a particularly high titer while the growth of titer of IgG antibodies is relatively small. A very high level of IgM, along with progressive growth of IgG antibodies and the related gradual decrease of the index value IgM/IgG, was observed in the serum of patients up to the 4th week of illness. In some cases, in titer known to be diagnostically significant, this high level was present even many months after the appearance of disease symptoms. Antibodies against M. pneumoniae in class of immunoglobulin A disappeared the fastest. Thus it is believed that demonstrating their characteristics dynamics or detecting these antibodies in the patient's serum in the titer assumed to be diagnostically significant can indicate an acute stage of illness.

摘要

本研究的目的是观察补体结合试验(CFT)、免疫电沉淀试验(IEPT)和酶联免疫吸附测定(ELISA)检测呼吸道感染患者特定组中支原体抗体的出现频率,并确定这些抗体与患者年龄和病程的相关性。对从404人采集的521份血清样本进行了检测;378份样本来自276例肺炎患者,143份来自128例上呼吸道感染患者。此外,在本研究的这一部分中,对50例百日咳患者的血清样本进行了检测,作为对照试验以证明检测的特异性。已确定,肺炎患者中支原体抗体的效价通常比上呼吸道感染患者高得多。随着年龄增长,所有三项检测中检测到的支原体抗体水平在受检患者中均有所上升。在21至50岁的成年人中检测到抗肺炎支原体的抗体效价最高。通常,支原体IgM抗体水平比IgG抗体高2至3倍。还表明,在疾病的第一周内,通过CFT、IEPT和ELISA检测的受检者血清中抗肺炎支原体抗体就高于已知具有诊断意义的水平。在疾病的第二周,IgA和IgM抗体效价特别高,而IgG抗体效价增长相对较小。在疾病第4周之前,患者血清中观察到IgM水平非常高,同时IgG抗体逐渐增加,相关的IgM/IgG指数值逐渐下降。在某些情况下,即使在疾病症状出现后数月,在已知具有诊断意义的效价中仍存在这种高水平。免疫球蛋白A类中的抗肺炎支原体抗体消失得最快。因此,人们认为,证明其特征性动态变化或在患者血清中检测到假定具有诊断意义效价的这些抗体可表明疾病的急性期。

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