目的 探讨间接酶联免疫吸附试验(indirect enzyme-linked immunosorbent assay,IELISA)在诊断人布鲁菌感染中的价值。方法 选取116例布鲁菌病（布病）确诊患者、66例疑似布病患者和72名健康对照者,采集静脉血,应用试管凝集试验（standard tube agglutination test,SAT）、IELISA、虎红平板凝集试验（Rose-Bengal plate agglutination test,RBPT）和血培养方法进行检测,以SAT检测结果为诊断标准,分析IELISA、RBPT和血培养方法在布病诊断中的价值。结果 SAT、IELISA、RBPT及血培养方法检测人血清布鲁菌在急性、慢性布病组中的阳性率(100%、100%;98.6%、97.9%;91.3%、91.5%;20.3%、10.6%)显著高于疑似布病组(0、6.0%、0、0,P均<0.05)及健康对照组(1.4%、0、2.8%、血培养未做,P均<0.01)。IELISA法与RBPT、SAT法间有较好的一致性(Kappa值为0.846和0.966)。IELISA检测的灵敏度(98.3%)和特异度(100%)最高;RBPT法的灵敏度和特异度则分别为91.4%和97.2%。结论 IELISA法具有较高的准确率,可更简便、迅速的对布病进行诊断。
Objective: To investigate the diagnostic value of indirect enzyme-linked immunosorbent assay (IELISA) for human Brucella infection. Methods: A total of 116 patients with confirmed Brucella infection were enrolled, and 66 suspected cases and 72 healthy subjects were served as controls. Venous blood was collected to detect Brucella antibody by standard tube agglutination test (SAT), IELISA, Rose-Bengal plate agglutination test（RBPT) and blood culture was performed for isolation of Brucella bacteria. Result of SAT test was taken as the golden standard, and the diagnostic value of IELISA, RBPT and blood culture were analyzed. Result: Positive rates of SAT, IELISA, RBPT and blood culture in confirmed acute (100%, 98.6%, 91.3%, 20.3%) and chronic Brucella infection patients (100%, 97.9%, 91.5%, 10.6%) were significantly higher than those in suspected patients (0, 6.0%, 0, 0, all P<0.05) and healthy controls (1.4%, 0, 2.8%, all P<0.01; blood culture not done). The IELISA was in good agreement with SAT and RBPT (Kappa=0.846, 0.966). The sensitivity (98.3%) and specificity (100%) of IELISA were the highest . Sensitivity and specificity of RBPT were 91.4% and 97.2%, respectively. Conclusions: Compared with RBPT and blood culture, IELISA has a better diagnostic accuracy for Brucella infection, and is more convenient and rapid.
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