【作者】 储峰； 季青； 严润民； 王霞明；

【Author】 Chu Feng, Ji Qing Yan Runmin, et al. Shanghai Nanhui Nanhua Hospital, Shanghai 201300

【机构】 上海市南汇区南华医院；

【摘要】 目的:为探索一种更为简便、快速、特异、灵敏的肾综合征出血热(HFRS)抗体的检测方法及更为有效的中西医结合治疗方法。方法:458例HFRS病人血清同时采用免疫滴金法(CGIDA)与酶联免疫吸附法(ELLISA)对比检测特异性免疫球蛋M抗体(抗HFRS-IgM)、免疫荧光法(IFAT)上对比检测特异性免疫球蛋G抗体(抗HFRS-IgG)并以20例发热待查、48例病毒性肝炎血清作对照。101例HFRS病人分组进行中西医结合治疗,治疗组用苦黄、参麦注射液联合黄芪汤,对照组用利巴韦林联合甘利欣注射液。结果:458例HFRS病人血清,以CGIDA法检测抗HFRS-IgM,阳性358例,与ELLISA法作结果评价时,CGIDA灵敏度80%,特异度100%;以CGIDA法检测抗HFRS-IgG,阳性386例,与IFAT法作结果评价时CGIDA灵敏度91%,特异度100%。治疗组50例与对照组51例用药后退热天数、主要症状缓解天数相似(P>0.05),尿蛋白消失及肾功能恢复天数,对照组优于治疗组(P<0.05),在越期方面,越休克期及从发热期直接进入多尿期,两组情况相似(P>0.05)。结论:CGIDA法检测HFRS特异性抗体分别与ELLISA法及IFAT法对照,均有简便、快速、特异、灵敏之优点,CGIDA法检测抗HFRS-IgM,敏感性差于ELLISA法,但是无假阳性;检测抗HFRS-IgG,CGIDA法的灵敏度高于IFAT法。苦黄、参麦注射液联合黄芪汤HFRS与利巴韦林联合甘利欣注射液相比较,疗效无明显差别,但前者优于改善休克情况,后者强于改善肾功能。更多还原

【Abstract】 Objective To explore a simple, speedy, specific and sensitivemethod to detect specific IgM (SIgM) and IgG (SIgG) antibody of hemorrhagic fever with renal syndrome(HFRS), To study the therapeuti effects of traditional and western medicine on HFRS. [Method] The serum of 458 patients with HFRS were tested with colloidal gold immuno-dot assay (CGIDA) for SIgM and SIgG antibody and compared with enzyme linked imraunosorbent assay (ELISA) or indirect fluorescent antibody test (IFAT) and a control group (20 fever of unknown cases and 48 hepatic cases). 101 patients with HFRS were randomized into a treatment group (n=50, kuhuang and Shenmai injection with Huangqi liquid) and a control group (n=51, Ribarvirin with Ganlixin injection). [Results] With CGIDA, the rate of specificity of detected SIgM was 100% and sensitivity was 80%, detection ofSIgGwas 100% too, sensitivity Was 91%. They weresim$ar duringthe fever declineddays, the symptoms alleviated days and sign relived days between treatment group and control group. Days for recovery from albuminuria and renewed kidney funetieri, the treatment group was better than the control one (P < 0.05). The crossed shock state rate of the treatment group was higher than that of the control one (P<0.05). [Conclusion] To detect the SIgM or SIgG antibody in serum of patients with HFRS, CGIDA was more simple and speedy, more specific and sensitive than ELISA or IF AT. Though the sensitivity of CGIDA was lower than that of ELISA, the CGIDA had no false positive reaction; the sensitivity of CGIDA was higher than of IF AT on detecting anti-HFRS IgG. About treating of HFRS, the effect of treatment group was similar to that of control group. But the crossed shock state rate in the treatment group was higher than that of control, the renewed kidney function in the control group was better than that in the treatment group.更多还原