【摘要】： 本研究觀察41例孢子絲菌病患者治療前血清IgG、IgM、IgA水平,并選取固定型孢子絲菌病患者(以下簡(jiǎn)稱固定型)及淋巴管型孢子絲菌病患者(以下簡(jiǎn)稱淋巴管型)各15例,觀察經(jīng)伊曲康唑聯(lián)合碘化鉀治療前后IgG、IgM、IgA水平的變化,及詳細(xì)報(bào)道一例播散型孢子絲菌病病例。本研究主要采用孢子絲菌脫落抗原酶聯(lián)免疫吸附試驗(yàn)(ELISA)間接測(cè)抗體法檢測(cè)特異性血清IgG、IgM、IgA,41例確診孢子絲菌病患者中95 %的患者在治療前檢出IgA,超過85 %的患者在治療前有IgM或IgG抗體。申克孢子絲菌在治療前期可誘導(dǎo)出IgG、IgM、IgA三種抗體,單個(gè)抗體中IgA的陽性檢出率最高,在治療前期100%可誘導(dǎo)出至少一種血清特異性抗體,而任意兩種抗體陽性的機(jī)率也達(dá)到了95.10%。在伊曲康唑聯(lián)合碘化鉀治療1個(gè)月前后(以下簡(jiǎn)稱聯(lián)合用藥)孢子絲菌病患者體內(nèi)抗體含量比較,固定型和淋巴管型兩種臨床類型的血清IgM和IgA均不同程度的表現(xiàn)為降低,P0.05,有顯著性意義,而IgG在臨床臨床類型治療前后的變化經(jīng)統(tǒng)計(jì)學(xué)計(jì)算P0.05,無顯著性意義。由此看出,該血清學(xué)檢測(cè)可以作為藥物療效觀察指標(biāo)及跟蹤隨訪患者病情變化而應(yīng)用于臨床,通過觀察抗體吸光度的改變指導(dǎo)診斷及觀察藥物療效,敏感度和特異度都得到證實(shí),是一種較好的檢測(cè)孢子絲菌病的實(shí)驗(yàn)室檢查方法,但仍需在結(jié)合臨床表現(xiàn)、病理活檢及真菌培養(yǎng)結(jié)果綜合作出診斷結(jié)論。
[Abstract]:In this study, serum IgG,IgM,IgA levels were observed in 41 patients with spore mycosis before treatment, and 15 patients with fixed sporocystis (fixed type) and 15 patients with lymphangiomycosis (lymphatic type) were selected. To observe the changes of IgG,IgM,IgA level before and after treatment with itraconazole and potassium iodide, and to report a case of disseminated sporocystis in detail. The purpose of this study was to detect IgA, in 95% of the patients with specific serum IgG,IgM,IgA,41 diagnosed by specific serum IgG,IgM,IgA,41 by enzyme linked immunosorbent assay (Elisa) with Abscisic antigen (Abscisic antigen) of sporocystis. IgA, was detected in 95% of the patients with Sporomycosis before treatment. More than 85% of patients had IgM or IgG antibodies before treatment. Three antibodies of IgG,IgM,IgA could be induced by Sporothrix schenckii before treatment. The positive rate of IgA was the highest in single antibody, and at least one serum-specific antibody could be induced in 100% of the patients before treatment. The probability of any two antibody positive also reached 95.10%. After treatment with itraconazole and potassium iodide for 1 month, the levels of serum IgM and IgA in patients with sporocystis were decreased in different degrees. There was significant difference in P0.05, but there was no significant difference in the changes of IgG before and after clinical type treatment (P0.05). It is concluded that this serological test can be used in clinical practice as an observation index of drug curative effect and follow up the change of patient's condition, and the change of antibody absorbance can be used to guide the diagnosis and observe the curative effect of the drug. The sensitivity and specificity have been proved to be a good laboratory method for the detection of spore hyphiliasis, but it is still necessary to make a comprehensive diagnosis conclusion by combining clinical manifestations, pathological biopsy and fungal culture results.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2010
【分類號(hào)】：R756.6

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