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目的比较外-斐反应(WFT)与胶体金免疫色谱法(CIA)对恙虫病血清学诊断价值的差异。方法采集恙虫病暴发期间患者的血清标本,以变形杆菌OXK、OX2及OX19抗原进行WFT检测,以CIA测定恙虫病东方体特异性抗体,比较两种血清学方法对恙虫病的实验诊断效能。结果共有18例恙虫病患者接受了CIA检测,阳性率为100%(18/18);其中9例住院患者同时接受了WFT和CIA检测,抗-OXKWFT阳性率为44.4%(4/9),CIA阳性率为100%(9/9),(P<0.01)。抗-OXKWFT诊断恙虫病的灵敏度为44.4%,特异度为94.1%,假阳性率为5.9%,假阴性率为55.6%。所有患者抗OX2及抗OX19均为阴性。结论抗-OXKWFT对恙虫病有一定诊断价值,但敏感性较差,假阴性率较高。CIA作为恙虫病血清学诊断的一种新方法,具有较高的敏感性和特异性。
Objective To compare the diagnostic value of WFT and colloidal gold immunochromatography (CIA) on the serological diagnosis of tsutsugamushi disease. Methods Serum samples of patients with tsutsugamushi disease were collected. WFT was performed on Proteus OXK, OX2 and OX19 antigens. CIA was used to determine oriental specific antibodies against tsutsugamushi. The diagnostic efficacy of the two serological methods in the diagnosis of tsutsugamushi disease was compared. Results A total of 18 tsutsugamushi patients were tested by CIA, with a positive rate of 100% (18/18). Nine of the 9 hospitalized patients received both WFT and CIA tests. The positive rate of anti-OXKWFT was 44.4% (4/9) The positive rate of CIA was 100% (9/9) (P <0.01). Anti-OXKWFT scrub typhus diagnosis of 44.4% sensitivity, specificity was 94.1%, false positive rate was 5.9%, false negative rate was 55.6%. All patients were negative for both OX2 and anti-OX19. Conclusion Anti-OXKWFT has a certain diagnostic value for scrub typhus, but its sensitivity is poor and its false negative rate is high. As a new method for the diagnosis of tsutsugamushi disease, CIA has higher sensitivity and specificity.