血吸虫病治疗前后IgG及其亚类的变化和疗效考核的研究

目的：欲寻找一种用于血吸虫病疗效考核的IgG亚类短期抗体。方法：用各种ELISA方法检测了264份治疗前和治疗后不同时间慢性血吸虫病人及50份正常人血清中的可溶性虫卵抗原（SEA）和成虫抗原（AWA）特异性IgG、IgG1和IgG4，以及日本血吸虫31／32kD肠相关抗原（GAA）。结果：治疗前IgG阳性率（SEA97．6％，AWA100％）与IgG1（SEA94％，AWA95．2％）无差别，高于IgG4（SEA62．7％，AWA73．4％）及GAA（62．7％）阳性率；治疗后IgG4消退较快，治疗后12月时阴转率达97．6％。正常血清检测上述四种指标假阳性率均在3％左右，无差别。结论：IgG1的诊断价值与IgG相仿，二者与粪检符合率均较高；而IgG4可能为一种短期抗体，可望作为疗效考核的评价指标。

Studies on the Detection of Specific IgG Subclasses and Its Evaluation of Therapeutic Efficacy in Schistosoma japonicum

We want to find a kind of short-duration antibodies which can be used to diagnosis schistosomiasis and indicate the successful treatment. METHODS: Both soluble egg antigens (SEA) and adult-worm antigens (AWA) of Schistosoma japonicum had been used to measure the specific IgG and IgG1/IgG4 in the sera of patients during the period of chronic S. japonicum infection and following therapy by using derect-and inderect ELISA. It was measured also at meantime that the 31/32kD gut-assosiated antigen(GAA)of S. japonicum in the sera. Those sera had 264 samples. The control sera (50 samples )came from normal persons who did not live in endemic are and were comfirmed by negative stool examination. RESULTS:The sensitivity of detecting anti-worm specific IgG1(AIgG1) was 95. 2%, and anti-egg specific IgG1(SIgG1) was 94%. The results were as same as that of detecting specific IgG while the sensitivity of detecting GAA was 62.7%. The specific IgG4 disappeared quickly after treatment. Both negative rates of AIgG4 (anti-worm specific)and SIgG4 (anti-egg specific)were 97.7% in 12 months after therapy. The false positive rates of IgG、IgG1、IgG4 and GAA were about 3% in the controlled sera. There were no significant meaning existed in those false positive rates. CONCLUSION:Detecting specific IgG/IgG1 had high value in diagnosing schistosomiasis. The specific IgG4 may be a short-duration antibody which can indicate successful chemotherapy of patient with chronic S. japonicum infection.