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《福建醫(yī)藥雜志》[ISSN:1002-2600/CN:35-1071/R]

卷:

39

期數(shù):

2017年3期

頁碼:

96-99

欄目:

實驗診斷與臨床

出版日期:

2017-06-15

文章信息/Info

Title:

Diagnostic value of lateral flow immunoassay and latex agglutination test in AIDS patients with cryptococcal infection

作者:

謝海花[1]; 張宇[2]; 吳紹貴[2]; 李圣聰[2]; 周淑燕[2]; 柳麗娟[2]

福建省立金山醫(yī)院福建省立醫(yī)院南院檢驗科福州350028福建醫(yī)科大學(xué)附屬傳染病醫(yī)院檢驗科

Author(s):

XIE Haihua[1]; ZHANG Yu[2]; WU Shaogui[2]; LI Shengcong[2]; ZHOU Shuyang[2]; LIU Lijuan[2]

關(guān)鍵詞:

艾滋病; 隱球菌莢膜多糖抗原; 隱球菌性腦膜炎; 膠體金免疫層析; 乳膠凝集試驗

Keywords:

AIDS; cryptococcal capsular antigen; cryptococcal meningitis; lateral flow immunoassay(LFA); latex agglutination test(LA)

分類號:

R446.61

摘要:

目的探討膠體金免疫層析法(LFA)和乳膠凝集試驗(LA)檢測隱球菌莢膜多糖抗原對艾滋病患者繼發(fā)隱球菌感染的診斷價值及治療觀察的臨床意義.方法采用LFA和LA對艾滋病患者繼發(fā)隱球菌感染治療前后的腦脊液標(biāo)本和血清標(biāo)本行隱球菌莢膜多糖抗原檢測,并與腦脊液墨汁染色和真菌培養(yǎng)進(jìn)行比較,評價其診斷的靈敏度和特異度.同時動態(tài)觀察治療期間隱球菌莢膜多糖抗原滴度的變化,和LFA的干擾因素.結(jié)果LFA和LA對腦脊液標(biāo)本隱球菌檢測的敏感度分別為97.73%和95.45%,血清標(biāo)本的敏感度也分別為97.73%、95.45%;對腦脊液標(biāo)本的特異性分別為95.83%、95.83%,對血清標(biāo)本的特異性分別為89.39%和87.12%.艾滋病繼發(fā)隱球菌感染患者腦脊液標(biāo)本中的隱球菌莢膜多糖抗原滴度隨著患者病情的好轉(zhuǎn)而逐漸下降,治療前后腦脊液和血清中莢膜抗原滴度差異均有統(tǒng)計學(xué)意義(t=6.309,P<0.001;t=6.814,P<0.001).結(jié)論LFA與LA適用于隱球菌腦膜腦炎患者的快速診斷;腦脊液隱球菌多糖莢膜抗原的動態(tài)監(jiān)測對艾滋病患者繼發(fā)隱球菌感染的療效觀察具有重要的參考價值.

Abstract:

Objective To explore the diagnostic value and clinical significance of lateral flow immunoassay (LFA) and latex agglutination test(LA)to detect cryptococcal capsular antigen in AIDS patients with cryptococcal infection.Methods The cryptococcal capsular antigen in CSF and serum were detected by LFA and LA,and compared with cerebrospinal fluid ink staining and fungal culture to evaluate its diagnostic sensitivity and specific degrees.The change of cryptococcal capsular antigen drop degree during treatment,and the interference factor of lateral flow immunoassay were observed dynamically.Results The sensitivity of LFA and LA for detection cryptococcus was 97.73% and 95.45% in cerebrospinal fluid specimens and serum specimen respectively.The specificity was 95.83% respectively in cerebrospinal fluid specimens and 89.39%,87.12% in serum specimen respectively.The cryptococcal capsular antigen drops of AIDS patients with cryptococcus infection in cerebrospinal fluid specimens fell gradually along with treatment.The difference of capsular antigen titer in cerebrospinal fluid and serum before and after treatment had statistical significance.Conclusion LFA and LA are suitable for the rapid diagnosis of cryptococcus meningoencephalitis patients.LFA can short detection time and be more simple to operate and confirm the results.Dynamic monitoring of cryptococcal capsular antigen in cerebrospinal fluid specimens has important reference value to observe the curative efficacy of AIDS patients with cryptococcal infection.

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