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目的探讨血清学TR/Patoc-Ⅰ株抗原的肉眼凝集试验(即快速玻片凝集反应)在钩端螺旋体病中的应用价值。方法对本院1995年7月～2004年5月收治的32例小儿病人进行临床综合分析。血清学检测采用快速玻片凝集反应,并与活抗原显微镜凝集试验相对照。结果快速玻片凝集反应全部阳性。+～++的16例双份血清3～4周后复查增高++以上的有13例。+++～++++的10例3～4周后降为+～++。双份血清升高或降低++以上的有27例,无变化的5例临床诊断均为闭塞性脑动脉炎。入院后1周内SAT和MAT二者敏感度经统计学卡方检验,统计学上有显著差异(P<0.01)。入院1周内SAT+以上的有32例,MAT抗体滴度1∶100以上的有24例,两者阳性率经卡方检测,统计学上有显著差异(P<0.01)。100例非钩体病儿童检验二者的特异性,经卡方检测,统计学上有显著差异(P<0.01)。32例成对标本中,入院后3～4周32例SAT与MAT均阳性,同时阴性为0例。入院后3～4周SAT与MAT一致率为100%。两者结果有一致性(P<0.01)。结论快速玻片凝集反应操作简便、快速、无传染性,并且准确、特异和敏感,对钩体病早期诊断有一定的价值,值得基层医院推广。
Objective To investigate the value of serological TR / Patoc-Ⅰ antigen agglutination test (ie, rapid slide agglutination) in leptospirosis. Methods The clinical data of 32 pediatric patients admitted to our hospital from July 1995 to May 2004 were analyzed comprehensively. Serological tests using rapid slide agglutination reaction, and live antigen microscopy agglutination test. Results Fast glass slide agglutination was all positive. + ~ + + 16 cases of double serum 3 ~ 4 weeks after the review increased ++ more than 13 cases. 10 cases of +++ ~ ++++ reduced to + ~ ++ in 3 ~ 4 weeks. 27 cases of double serum elevated or decreased ++ or more, no change in 5 cases of clinical diagnosis of occlusive cerebral arteritis. The sensitivity of both SAT and MAT within 1 week after admission was statistically significant (P <0.01) by statistical chi-square test. There were 32 cases with SAT + within 1 week after admission and 24 cases with MAT titer above 1: 100. The positive rates of both were statistically significant (P <0.01). 100 cases of non-leptospirosis children test the specificity of the two, the chi-square test, statistically significant differences (P <0.01). 32 pairs of specimens, 3 to 4 weeks after admission 32 cases of SAT and MAT were positive, while the negative was 0 cases. 3 to 4 weeks after admission SAT and MAT consistent rate of 100%. The results were consistent (P <0.01). Conclusion The rapid slide agglutination reaction is simple, rapid and non-contagious. It is accurate, specific and sensitive and has certain value for the early diagnosis of leptospirosis. It is worth to be popularized in primary hospitals.