莱姆病伯氏疏螺旋体抗体的酶免疫测定

R. F. Sayfullin, N. N. Zvereva, М. А. Saifullin, S. Smetanina, E. V. Kardonova, O. Shamsheva
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引用次数: 1

摘要

酶免疫测定法(ELISA)对伯氏疏螺旋体抗体的检测在很大程度上取决于疾病发病的时间。目的:分析莱姆病(Lyme borreliosis, LB)儿童和成人发病后不同时期的伯氏螺旋体抗体检测结果。材料和方法。我们进行了一项回顾性、非随机、单中心队列研究,分析了178例确诊为LB的患者门诊记录和ELISA抗体检测结果。采用在俄罗斯联邦境内注册的ELISA和western blot检测系统分别检测针对伯氏疏螺旋体M类和g类抗原的免疫球蛋白,对LB的诊断进行免疫学确认。从发病之日算起,76%的患者在4-6周检测到IgM和/或IgG, 95%的患者从第7周开始检测。从蜱虫叮咬日期开始计数,从第7周开始,83%的患者检测到IgG伴或不伴IgM。同时,儿童中血清阴性患者的比例也非常大。我们明确了抗菌治疗后抗体持续时间。在1至6个月的时间间隔内,73%的患者检测到抗体。在6个月或更长时间内,42%的患者可检测到抗体。从发病开始检测抗体的最佳时间为4-6周。抗生素治疗后的抗体可以持续很长时间,在三分之一的患者中长达6个月或更长时间。
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Detection of antibodies to B. burgdorferi by enzyme immunoassay in patients with Lyme borreliosis
The detection of antibodies to borrelia by enzyme immunoassay (ELISA) significantly depends on the time from the onset of the disease.Purpose: analysis of the results of antibodies determination to borrelia by ELISA in children and adults with Lyme borreliosis (LB) at various periods from the onset of the disease.Material and methods. We conducted a retrospective, non-randomized, single-center cohort study, based on the analysis of data from 178 outpatient records of patients with a confirmed diagnosis of LB and the presence of antibody detection results by ELISA. Immunological confirmation of the diagnosis of LB was carried out by using ELISA and western blot test systems registered in the territory of the Russian Federation for the separate determination of immunoglobulins to Borrelia burgdorferi antigens of classes M and G. Results. When counting from the date of the onset of the disease, IgM and/or IgG were determined in 76% of patients at 4-6 weeks, and starting from the 7th week – in 95%. When counting from the date of tick bite, IgG with or without IgM was determined in 83% of patients starting from 7th week. At the same time, a significantly large proportion of seronegative patients among children was revealed. We have clarified the duration of antibody persistence after antibacterial therapy. In the interval from 1 to 6 months, antibodies are detected in 73% of patients. For a period of 6 months or more, antibodies can be detected in 42% of patients.Conclusion. The optimal time for detecting antibodies from the disease onset is 4-6 weeks. Antibodies after antibiotic therapy can persist for a long time, in a third of patients up to 6 months or more.
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