HLA-B27在门诊疑似AS诊断中的意义

目的讨论门诊疑似强制性脊柱炎(AS)诊断中HLA-B27基因检测的意义。方法对门诊疑似诊断为AS的889例患者的HLA-B27阳性率、患者性别和初诊年龄进行统计分析,并与同期随机采集的506例健康人的HLA-B27阳性率进行比较。结果 889例门诊疑似AS患者中HLA-B27阳性率为44.77%(398/889),其中男性患者的HLA-B27阳性率47.55%(339/713)与女性患者的35.52%(59/176)相比,差异具有显著统计学意义(χ2=11.23,P<0.01);对照组中HLA-B27阳性率为4.15%(21/506),与疑似AS患者的阳性率相比,呈显著统计学差异(χ2=253.18,P<0.001);男性患者发病高峰为11-20岁,而女性患者则为31-40岁。结论疑似AS患者就诊时检测HLA-B27有助于提高初诊患者诊断率,可作为鉴别诊断的重要指标。     

PCR-SSP法检测29种HLA-B27基因亚型

目的采用聚合酶链反应-序列特异性引物(PCR-SSP)高分辨技术检测29种HLA-B27基因亚型。方法设计并合成HLA-B27亚型特异性引物35条(配对组成上下游引物组合29对)以及一对内对照引物,建立PCR-SSP方法,用于B27亚型分型。检测标本为117例HLA-B27阳性研究对象(男79名,女38名)外周血DNA。结果 117例标本的PCR-SSP扩增均获得成功,成功构建了PCR-SSP检测反应体系。共检测出6种亚型:B*2702、B*2703、B*2704、B*2705、B*2706及B*2713,六种亚型的构成比分别为:0.85%、6.84%、64.10%、25.64%、1.71%和0.85%,其中B*2704和B*2705为中国汉族人群中主要亚型。结论应用该新型PCR-SSP高分辨技术进行HLA-B27基因亚型检测,能检测出较多HLA-B27亚型,且该法进行B27亚型分型分辨度高,特异性强,成本较低,适合于临床应用。     

血清学技术与DNA技术检测HLA-B27的比较

目的比较血清学技术与DNA技术检测HLA-B27对诊断强直性脊椎炎的临床价值。方法采用微量淋巴细胞毒试验检测HLA-B27抗原和DNA技术检测HLA-B27基因方法检测58例患者标本,结合临床诊断进行比较分析。结果58例标本中31例检出B27基因,其中28例符合AS临床诊断标准;24例血清学方法检出B27抗原,3例结果可疑。结论DNA技术检测HLA-27比血清学技术敏感、快速,更适合于临床应用。     

流式细胞仪检测HLA-B27抗体用量的探讨

目的探讨检测HLA-B27流式细胞仪抗体用量问题。方法采用三种不同标本量及抗体量的方法，用自配试剂同时检测病人HLA-B27。结果同种试剂采用不同标本及抗体用量，其结果均无显著性差异（P〉0．05）。结论同时减少单克隆抗体及标本用量并不影响实验结果，在经济不发达地区，值得推广应用。     

湖南地区强直性脊柱炎与HLA-B27关联性的观察

目的　探讨湖南地区 HL A- B2 7对强直性脊柱炎的诊断意义。　方法　对临床疑为强直性脊柱炎的患者静脉血采用玻璃珠抗凝分离淋巴细胞并用标准的 Terasaki软滴法作微量淋巴细胞毒试验。结果疑为强直性脊柱炎患者 6 47例 ,其中男性 481例 ,女性 16 6例 ,男女比例为 3:1。 B2 7阳性率为 5 6 .5 7% ,其中男性占 6 7.15 % ,女性占 2 5 .90 %。发病年龄主要集中在青少年时期。　结论　 HL A- B2 7血清学检测对强直性脊柱炎的诊断和鉴别诊断具有重要意义。     

江西省艾滋病病毒感染者HLA-B*5701阳性率的研究

目的研究江西省人免疫缺陷病毒(HIV)感染者中的HLA-B*5701阳性率,并比较国内外其他民族的相关研究数据。方法样品来自部分2010江西省11个设区市新报告的HIV阳性人群中确证后首次CD4细胞计数在400-500个/UL之间者,提取其全血基因组DNA,采用序列特异性引物(SSP)进行聚合酶链反应(PCR),并对HLA-B*5701阳性样本结果通过测序进行HLA-B基因分型验证。结果 500名艾滋病病毒(HIV)感染者中,3人携带HLA-B*5701等位基因,阳性率为0.6%。结论江西省人群HIV感染者中的HLA-B*5701阳性率低于黑种人及白种人的研究数据,江西汉族人群与中国南方其他汉族人群相比较差异无统计学意义。     

379例疑似强直性脊柱炎患者HLA-B27抗原检查结果分析

目的本文是为了总结本地区强直性脊柱炎与HLA-B27抗原的相关情况.方法我们采用的是淋巴细胞毒实验Teraski血清盘法.结果379例疑似强直性脊柱炎患者的HLA-B27抗原检查阳性的有124例,阴性为255例.结论本地区强直性脊柱炎与HLA-B27抗原有极强相关.     

两种方法对HLA-Ⅰ、Ⅱ类分型结果的比较

目的比较PCR—SSP基因分型与血清学抗原分型两种HLA分型方法的应用结果。方法对62例已进行HLA血清学分型的肾脏移植患者,应用PCR-SSP法进行HLA—I类(A、B位点)、Ⅱ类(DR、DQ位点)基因进行扩增分型。结果基因分型结果与血清学分型一致者52例,基因分型能明显判断而血清学分型无法判断者10例,其中B位点6例,DR位点3例,DQ位点1例。结论 PCR-SSP方法具有操作简单、快速、结果可靠的特点,特别是对HLA-I类的B位点及II类的结果判定比血清学分型方法更准确,能满足组织配型的需要。血清学方法操作简单、快捷,但存在一定错配现象。     

父源性HLA-B基因与子痫前期相关性的研究

目的:探讨父源性人类白细胞分化抗原HLA-B基因与子痫前期的相关性。方法:利用流式反向特异序列寡核苷酸探针(PCR-SSO)基因分型技术,对中国地区汉族人群中37对子痫前期患者夫妇及38对正常孕妇夫妇的外周血DNA,进行HLA-B等位基因分型;分别比较两组母亲之间和两组配偶之间等位基因及基因型的频率分布,通过妇/夫基因型配伍,比较两组间基因型配伍频率分布的差异。结果:①子痫前期患者和正常晚孕者中检出34个HLA-B等位基因;配偶中检出28个HLA-B等位基因;两组孕妇及其配偶间HLA-B基因频率均无统计学差异;②子痫前期组妇携带HLA-B13夫不携带HLA-B13基因的频率显著高于正常晚孕组(P<0.05);③子痫前期组夫妇均不携带HLA-B13基因的频率显著低于正常晚孕组(P<0.05)。结论:夫妇间的某些特定HLA-B基因配伍模式可能与子痫前期的发病相关。     

儿童强直性脊柱炎HLA-B27抗原表达与骨损害关系的临床研究

目的探讨HLA—B27表达与儿童强直性脊柱炎骨代谢功能损伤的关系。方法检测HIA—B27不同型别的儿童强直性脊柱炎患者和对照群体骨代谢功能指标。结果分析显示各实验组间各项指标存在有不同程度的差异（FCT=87．3，P〈0．01；FBGP=197．1，P〈0．01），具体表现为：（可检测水平B27＋AS〉B27-AS〉B27＋对照和B27-对照（q12=7．48，q13=16．33，q14=20．87，q23=9．01，q24=12．47，P均〈0．01），而B27＋和B27-对照之间差异无显著意义（q34=2．33，P〉0．05）；BGP检测水平B27＋AS〉B27-AS〉B27＋对照和B27-对照（q12=11．6，q13=25．8，q14=30．7，q23=14．3，q24=17．7，P均〈0．01），而B27＋和B27-对照之间差异亦无显著意义（q34=1．69，P〉0．05）。结论儿童强直性脊柱炎HLA—B27的表达与骨质损害具有一定的关联性，为临床深入研究提供了有益的线索。     

HLA-B27 3种检测方法的比较

目的：比较3种HLA-B27检测方法的敏感度、特异性、适用性。方法：采用微量淋巴细胞毒试验、PCR-SSP和流式细胞仪方法同时检测128份待检标本HLA-B27。结果：淋巴细胞毒试验、PCR-SSP和流式细胞仪方法敏感度、特异性、阳性预测价值、阴性预测价值分别为0.468、0.975、0.917、0.759;1.000、0.988、0.979、1.000;0.978、1.000、1.000、0.988。PCR-SSP和流式细胞仪方法敏感度显著性高于淋巴细胞毒试验,两两比较P〈0.01;阴性预测价值优于淋巴细胞毒试验,两两比较P〈0.05。结论：PCR-SSP和流式细胞仪方法均优于淋巴细胞毒试验,具有较好的临床适用性。     

Role of HLA-B51 and HLA-B52 in susceptibility to pulmonary tuberculosis

MHC class I-restricted CD8+ T cells are important for the generation of protective immune responses in MTB infection. CD8+ CTL (cytotoxic T-lymphocyte)-derived IFN-g may be especially important both for cells lacking MHC class II molecules, e.g. in the lung and for macrophages where mycobacteria can evade recognition during chronic infection by sequestering their antigens away from sensitized CD4+ T cells. This study was designed to detect any association of MHC class I (HLA-B) molecules with pulmonary tuberculosis. A total of 75 individuals, comprising of 33 patients with pulmonary tuberculosis; 12 HIV patients who developed tuberculosis and 30 healthy controls, were included in the study. They were typed for HLA-B by the PCR-SSP method. The results of only HLA-B alleles, which are highly significant, are presented here. The number of healthy individuals with HLA-B52 was significantly high when compared to the patient groups (healthy versus TB: 21.2% versus 0.0%, OR=0.0, P<0.0001, P(c)=0.003; healthy versus HIV-TB: 21.2% versus 16.7%; OR=0.74; P<0.001; P(c)=0.003). In contrast, the number of patients, both TB- and HIV-TB-positive, with HLA-B51 was significantly high when compared to the healthy group of individuals (TB versus healthy: 36.7% versus 3%; OR=18.53; P<0.0001; P(c)=0.001; HIV-TB versus healthy: 41.7% versus 3%; OR=22.86; P<0.0001; P(c)=0.001). Only one healthy control was positive to HLA-B51; however this individual also had HLA-B52. The results of this study suggest that HLA-B52(5) has a negative, i.e. a protective association and HLA-B51(5) has a positive (susceptible) association, for pulmonary tuberculosis. Studies on HLA-B51 and HLA-B52 in a larger population to assess their role in tuberculosis may be useful for TB-vaccination strategies, since HLA profiles are likely to be related to vaccine efficacy.     

流式HLA-B27测定法在强直性脊椎炎诊断中的临床价值

目的对流式细胞仪(FCM)B27/B7双标法用于强直性脊椎炎(AS)患者B27基因表达情况的测定进行评估;探讨B27平均荧光强度用于原发性AS及继发性脊椎炎鉴别诊断的可能性。方法采用FCM双标法、微量淋巴细胞毒试验(CDC)及引物特异性多聚酶链反应(SSP-PCR),对76例正常人、57例原发AS和106例继发脊椎炎患者进行B27测定。结果 CDC、SSP-PCR和FCM双标法特异性和敏感性分别为76.3%和78.5%、88.4%及86.3%、86.8%和88.85%。原发性AS及继发性脊椎炎患者B27平均荧光强度差异无统计学意义(P0.05)。结论 FCM HLA-B27/B7双标法是一种快捷、简便、高效的HLA-B27检测方法。     

三种梅毒血清学检验方法在临床中的应用

目的：筛选有效的检测试剂,提高临床诊断符合率。方法：选取2011年12月-2012年12月的职业健康体检10286例标本,采用对酶联免疫吸附试验（ELISA）、甲苯胺红不加热血清试验（TRUST）、梅毒螺旋体明胶颗粒凝集试验（TPPA）3种血清学检测方法进行梅毒诊断,并作结果分析。结果：ELISA法检出阳性标本675例中,经TPPA确证阳性657例,阳性符合率97.33%。TRUST法检出阳性424例,均经TPPA确证阳性;而ELISA筛查阳性而TRUST阴性的标本有7.17%的假阳性结果。结论：建议3种检测方法结合应用能更有效提高梅毒临床诊断符合率。     

应用铜绿假单胞菌4种分型方法的探讨

目的 以铜绿假单胞菌为例,探讨几种分型方法在医院感染监测中的应用。方法 结合检验工作,先后用生物分型、抗菌谱分型、血清分型和质粒图谱分型,再交互分析其关系。结果 97株菌分11个生物型,18个抗菌谱型,9个血清型与18个质粒谱型,但分型率高低不一。在两处铜绿色假单胞菌感染流行中,显示诸分型方法有某种程度的的一致性与互补性。结论 上述4种分型方法繁简不一,提供的信息有深有浅,其分型结果可在一定条件下把细菌检验工作与医院感染监测工作有效地结合起来,用于临床流行病学调查。     

Detection of dengue cases by serological testing in a dengue vaccine efficacy trial: Utility for efficacy evaluation and impact of future vaccine introduction

BackgroundDengue diagnosis confirmation and surveillance are widely based on serological assays to detect anti-dengue IgM or IgG antibodies since such tests are affordable/user-friendly. The World Health Organization identified serological based diagnosis as a potential tool to define probable dengue cases in the context of vaccine trials, while acknowledging that this may have to be interpreted with caution.MethodsIn a phase IIb randomized, placebo-controlled trial assessing the efficacy of a tetravalent dengue vaccine (CYD-TDV) in Thai schoolchildren, case definition was based on virological confirmation by either serotype-specific RT-PCRs or by NS1-antigen ELISA (Clinicaltrials.gov NCT00842530). Here, we characterized suspected dengue cases using IgM and IgG ELISA to assess their utility in evaluating probable dengue cases in the context of vaccine efficacy trials, comparing virologically-confirmed and serologically diagnosed dengue in the vaccine and placebo groups. Serologically probable cases were defined as: (1) IgM positive acute- or convalescent-phase samples, or (2) IgG positive acute-phase sample and ≥4-fold IgG increase between acute and convalescent-phase samples.ResultsSerological diagnosis had good sensitivity (97.1%), but low specificity (85.1%) compared to virological confirmation. A high level of false positivity through serology diagnosis particularly in the 2 months post-vaccination was observed, and is most likely related to detection of the immune response to the dengue vaccine. This lack of specificity and bias with vaccination demonstrates the limitation of using IgM and IgG antibody responses to explore vaccine efficacy.ConclusionReliance on serological assessments would lead to a significant number of false positives during routine clinical practice and surveillance following the introduction of the dengue vaccine.     

Utility of serological follow-up of chronic strongyloidiasis after anthelminthic chemotherapy

The difficulty of establishing a diagnosis and confirming cure of strongyloidiasis is widely appreciated. As parasitological diagnosis is often unsatisfactory, serodiagnosis is frequently relied upon. The aim of this study was to investigate changes in Strongyloides-specific antibody levels among a group of 79 seropositive Indigenous Australians living in a Strongyloides-endemic region. Testing before and after treatment revealed that seroreversion occurred most commonly after multiple courses of ivermectin therapy, with antibody titres of 35/42 (83%) subjects becoming negative. Seroreversion was also common following a single course of ivermectin or multiple courses of a 3-day regimen of albendazole, with seroreversion occurring in 13/19 (68%) and 7/10 (70%) subjects respectively. One 3-day course of albendazole was less effective with 4/10 (40%) subjects seroreverting, whereas none of the five subjects receiving a single dose of albendazole and 1/10 (10%) of subjects receiving no therapy seroreverted. These results support the use of serological follow-up for strongyloidiasis, and indicate that reversion to negative serostatus after ivermectin therapy is frequent.