联合药物治疗孢子丝菌病患者血清IgG、IgM、IgA检测

发布时间：2018-11-22 09:57

【摘要】： 本研究观察41例孢子丝菌病患者治疗前血清IgG、IgM、IgA水平,并选取固定型孢子丝菌病患者(以下简称固定型)及淋巴管型孢子丝菌病患者(以下简称淋巴管型)各15例,观察经伊曲康唑联合碘化钾治疗前后IgG、IgM、IgA水平的变化,及详细报道一例播散型孢子丝菌病病例。本研究主要采用孢子丝菌脱落抗原酶联免疫吸附试验(ELISA)间接测抗体法检测特异性血清IgG、IgM、IgA,41例确诊孢子丝菌病患者中95 %的患者在治疗前检出IgA,超过85 %的患者在治疗前有IgM或IgG抗体。申克孢子丝菌在治疗前期可诱导出IgG、IgM、IgA三种抗体,单个抗体中IgA的阳性检出率最高,在治疗前期100%可诱导出至少一种血清特异性抗体,而任意两种抗体阳性的机率也达到了95.10%。在伊曲康唑联合碘化钾治疗1个月前后(以下简称联合用药)孢子丝菌病患者体内抗体含量比较,固定型和淋巴管型两种临床类型的血清IgM和IgA均不同程度的表现为降低,P0.05,有显著性意义,而IgG在临床临床类型治疗前后的变化经统计学计算P0.05,无显著性意义。由此看出,该血清学检测可以作为药物疗效观察指标及跟踪随访患者病情变化而应用于临床,通过观察抗体吸光度的改变指导诊断及观察药物疗效,敏感度和特异度都得到证实,是一种较好的检测孢子丝菌病的实验室检查方法,但仍需在结合临床表现、病理活检及真菌培养结果综合作出诊断结论。
[Abstract]:In this study, serum IgG,IgM,IgA levels were observed in 41 patients with spore mycosis before treatment, and 15 patients with fixed sporocystis (fixed type) and 15 patients with lymphangiomycosis (lymphatic type) were selected. To observe the changes of IgG,IgM,IgA level before and after treatment with itraconazole and potassium iodide, and to report a case of disseminated sporocystis in detail. The purpose of this study was to detect IgA, in 95% of the patients with specific serum IgG,IgM,IgA,41 diagnosed by specific serum IgG,IgM,IgA,41 by enzyme linked immunosorbent assay (Elisa) with Abscisic antigen (Abscisic antigen) of sporocystis. IgA, was detected in 95% of the patients with Sporomycosis before treatment. More than 85% of patients had IgM or IgG antibodies before treatment. Three antibodies of IgG,IgM,IgA could be induced by Sporothrix schenckii before treatment. The positive rate of IgA was the highest in single antibody, and at least one serum-specific antibody could be induced in 100% of the patients before treatment. The probability of any two antibody positive also reached 95.10%. After treatment with itraconazole and potassium iodide for 1 month, the levels of serum IgM and IgA in patients with sporocystis were decreased in different degrees. There was significant difference in P0.05, but there was no significant difference in the changes of IgG before and after clinical type treatment (P0.05). It is concluded that this serological test can be used in clinical practice as an observation index of drug curative effect and follow up the change of patient's condition, and the change of antibody absorbance can be used to guide the diagnosis and observe the curative effect of the drug. The sensitivity and specificity have been proved to be a good laboratory method for the detection of spore hyphiliasis, but it is still necessary to make a comprehensive diagnosis conclusion by combining clinical manifestations, pathological biopsy and fungal culture results.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2010
【分类号】：R756.6

【参考文献】