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目的探讨日本血吸虫病不同流行程度流行区IHA法的阳性诊断阈值。方法选择江西省鄱阳湖区湖沼型血吸虫病流行区2个县(余干和星子)共55个自然村作为研究现场,对5岁以上常住居民采用病原学方法(Kato-Katz法+尼龙绢集卵孵化法)和血清学方法(IHA法)进行平行检测;检测结果采用相关分析和ROC曲线等方法分析,计算不同流行程度流行区IHA抗体水平阳性临界值。结果血吸虫病流行区人群粪检阳性率与人群IHA血吸虫病特异性抗体水平分布趋势一致(r=0.588,P<0.05),与IHA阳性人群抗体水平无相关性(r=0.221,P>0.05);流行区2008-2011年连续4年血吸虫粪检阴性人群的IHA阳性抗体水平呈逐年下降趋势,年间差异有统计学意义(F=3.650,P<0.05),2008-2011年中任意1年血吸虫粪检阳性人群的IHA阳性抗体水平在4年内均维持较高水平且年间差异无统计学意义(F=2.461,P>0.05)。流行村人群粪检阳性率<1%、1%~5%和>5%时,对应IHA的阳性诊断阈值分别为1∶80、1∶20和1∶10时,可提高IHA检测结果的特异性。结论不同程度流行区采用IHA筛查血吸虫病或选择化疗对象时,可考虑选择不同的IHA阳性诊断阈值。
Objective To investigate the positive diagnostic threshold of IHA method in endemic areas of schistosomiasis japonica. Methods A total of 55 natural villages in 2 counties (Yugan and Xingzi) of lakeshore schistosomiasis endemic areas in Poyang Lake area of Jiangxi Province were selected as study sites. The etiological agents (Kato-Katz + nylon eggs hatched Method) and serological method (IHA method). The detection results were analyzed by correlation analysis and ROC curve method, and the positive critical value of IHA antibody level in different endemic areas was calculated. Results The positive rate of fecal semen in the endemic area of schistosomiasis was consistent with that of IHA schistosomiasis patients (r = 0.588, P <0.05), but not with the IHA positive population (r = 0.221, P> 0.05) . The prevalence of IHA positive antibody in the negative population of schistosomiasis control population in 2008-2011 showed a decreasing trend year by year in 2008-2011, with significant difference between the years (F = 3.650, P <0.05) The levels of IHA positive antibody in the fecal positive population remained high for 4 years and there was no significant difference between years (F = 2.461, P> 0.05). The prevalence of fecal seizures in epidemic villages was <1%, 1% to 5%, and> 5%, and the positive IHA diagnostic thresholds were 1:80, 1:20 and 1:10, respectively, Sex. Conclusion IHA screening for schistosomiasis or chemotherapy in different degrees of endemic areas may be considered when choosing different IHA positive diagnostic thresholds.