摘要目的 评价眼内液犬弓蛔虫特异性IgG抗体检测在眼弓蛔虫病诊断中的作用.方法 临床确诊为眼弓蛔虫病的50例患者(眼弓蛔虫病组)、就诊于耳鼻喉科的152例患者(血清对照组)及就诊于眼科的70例其他病患者(眼内液对照组)纳入研究.眼弓蛔虫病组收集房水样本28份,玻璃体液样本22份,血清样本50份;血清对照组收集血清样本152份;眼内液对照组收集房水样本46份,玻璃体液样本24份.采用酶联免疫吸附试验检测所有受检者眼内液及血清中犬弓蛔虫特异性IgG抗体的阳性率.同时对眼弓蛔虫病组患者的血清及眼内液样本进行配对检测,对比分析两者之间的犬弓蛔虫特异性IgG水平的差异.结果 眼弓蛔虫病组血清犬弓蛔虫特异性IgG阳性率为68.00％,U值为20.42±17.01;眼内液犬弓蛔虫特异性IgG阳性率为88.00％,U值为25.72±23.04.血清对照组血清犬弓蛔虫特异性IgG阳性率为2.63％,U值为2.37±2.71;眼弓蛔虫病组患者血清特异性IgG水平较血清对照组明显偏高,差异有统计学意义(Z=8.962,P=0.000).眼内液对照组未见眼内液犬弓蛔虫特异性IgG阳性者,U值为0.69±0.34;眼弓蛔虫病组患者眼内液特异性IgG水平较眼内液对照组明显偏高,差异有统计学意义(Z=8.120,P=0.000).眼弓蛔虫病组50例患者中,血清及眼内液犬弓蛔虫特异性IgG均为阳性者28例,占56.00％;血清犬弓蛔虫特异性IgG阳性,而眼内液犬弓蛔虫特异性IgG阴性者6例,占12.00％;血清犬弓蛔虫特异性IgG阴性,而眼内液犬弓蛔虫特异性IgG阳性者16例,占32.00％.血清与眼内液犬弓蛔虫特异性IgG阳性率比较,差异有统计学意义(x2=4.720,P=0.028).眼弓蛔虫病组患者的血清及眼内液样本配对检测结果显示,32例患者的眼内液犬弓蛔虫特异性IgG水平高于血清样本,占64.00％.结论 眼内液犬弓蛔虫特异性IgG抗体检测相对于血清具有更高的检出率.眼内液与血清犬弓蛔虫特异性IgG抗体的共同检测可能具有更好的诊断价值.

abstractsObjective To evaluate the clinical value of detecting specific IgG against Toxocara canis in intraocular fluid for the diagnosis of ocular toxocariasis(OT).Methods Fifty patients diagnosed as having OT(OT group),152 otolaryngology patients (serum control group) and 70 other oculopathy patients (intraocular fluid control group) were enrolled in the study.Intraocular fluids(28 aqueous humor and 22 vitreous humor) and serum samples of OT group were analyzed for specific IgG against Toxocara canis by enzymelinked immunosorbent assay,so were the intraocular fluids (46 aqueous humor and 24 vitreous humor) and 152 serum samples of two control group.Specific IgG level was compared between paired serum and intraocular fluids of OT group.Results 68.00％ serum samples of OT group were positive for specific IgG against Toxocara canis and the U value was 20.42±17.01.The positive rate was 88.00％ and U value 25.72±23.04 in intraocular fluids.In serum control group,it was 2.63％ and 2.37±2.71 respectively.The intraocular fluids were negative and U value 0.69 ± 0.34 in intraocular fluid control group.The difference of specific IgG level was proved significant between OT group and control group in both serum and intraocular fluid (Z=8.962,8.120; P=0.000,0.000).Twenty-eight patients (56.00％) were positive for specific IgG in both serum and intraocular fluid.Six patients (12.00％) were positive only in serum,and 16 patients (32.00％) only in intraocular fluid.The positive rate was significantly higher in intraocular fluid than in serum (x2 =4.720,P=0.028).Moreover,64.00％ intraocular fluid showed higher specific IgG level than pared serum.Conclusion The complementary detection of intraocular specific IgG have referential value in diagnosing ocular toxocariasis.