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[帕拉西特F用于恶性疟原虫疟疾的诊断]

[ParaSight F in the diagnosis of Plasmodium falciparum malaria].

作者信息

Bellagra N, Ajana F, Caillaux M

机构信息

Service de Parasitologie-Mycologie, Centre Hospitalier de Tourcoing, France.

出版信息

Pathol Biol (Paris). 1998 May;46(5):301-6.

PMID:9769889
Abstract

The ParaSight F is a new diagnostic test for Plasmodium falciparum infections and is based on the detection of a trophozoite-derived antigen, the histidine rich protein II (HRP-II). To assess the usefulness of this test, we conducted a prospective study and analyzed 62 blood specimens from 38 patients, using thin blood films, thick blood films and the ParaSight F test. Compared to thick blood film, on samples taken before and during treatment, the ParaSight F test had 86.4% sensitivity and 100% specificity. In 31.5% of P. falciparum infected patients, parasitemia was lower than 1 parasite/1000 red blood cells, with all specimens being positive by the ParaSight F test. In 15 cases, specimens were negative by thin blood film, but were positive by thick blood film and by the ParaSight F test. Two patients had, after their treatment was started, positive results by ParaSight F and negative results by thick blood film. Cross-reactivity occurred neither with other Plasmodium species, nor in cases of severe inflammatory syndrome. Persistence of antigenemia was monitored in 14 patients receiving quinine. At day five of treatment, antigenemia persisted in seven patients. In conclusion, the ParaSight F test does not allow following up the efficacy of treatment, identifying other Plasmodium species, or assessing parasitemia. However, because this test is easy to perform and has good sensitivity and specificity, it is a useful tool in emergent context, in cases of parasitemia lower than the thin blood film threshold, and in cases morphologically difficult to decipher.

摘要

ParaSight F是一种用于检测恶性疟原虫感染的新型诊断测试,它基于对一种滋养体衍生抗原——富含组氨酸蛋白II(HRP-II)的检测。为评估该测试的实用性,我们进行了一项前瞻性研究,使用薄血膜、厚血膜和ParaSight F测试对38例患者的62份血液标本进行了分析。与厚血膜相比,在治疗前和治疗期间采集的样本上,ParaSight F测试的灵敏度为86.4%,特异性为100%。在31.5%的恶性疟原虫感染患者中,疟原虫血症低于1个寄生虫/1000个红细胞,所有标本经ParaSight F测试均为阳性。在15例病例中,薄血膜标本为阴性,但厚血膜和ParaSight F测试为阳性。两名患者在开始治疗后,ParaSight F测试结果为阳性,厚血膜测试结果为阴性。该测试与其他疟原虫物种均无交叉反应,在严重炎症综合征病例中也无交叉反应。对14例接受奎宁治疗的患者的抗原血症持续情况进行了监测。在治疗的第5天,7例患者的抗原血症持续存在。总之,ParaSight F测试无法用于监测治疗效果、识别其他疟原虫物种或评估疟原虫血症。然而,由于该测试操作简便,具有良好的灵敏度和特异性,在紧急情况下、疟原虫血症低于薄血膜阈值的病例以及形态学上难以判别的病例中,它是一种有用的工具。

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