标题：双抗原夹心ELISA法检测抗念珠菌烯醇化酶抗体

      作者：汪俊，吴福珍，焦继光    (深圳市宝安区石岩人民医院检验科，广东 深圳 518100)

      卷次： 2018年29卷13期

      【摘要】 目的 探讨双抗原夹心ELISA法对抗念珠菌烯醇化酶抗体的检测效果。方法 选择2015年1月至2017年11月在深圳市宝安区石岩人民医院住院并经临床观察和实验室血培养结果确诊为侵袭性念珠菌病60例、念珠菌定植者40例、烟曲霉菌感染者40例，以健康体检者100例作为对照，应用双抗原夹心ELISA法对血液中的抗念珠菌烯醇化酶抗体进行检测，ROC曲线分析该检测方法的诊断敏感性、特异性以及最佳预测值。结果 ROC曲线显示，双抗原夹心ELISA法测定抗念珠菌烯醇化酶抗体线下面积为0.861，最佳预测值为0.211，此时其诊断敏感度及特异度分别为 93.4%和 82.8%，约登指数为 0.718，95%CI为 0.722~0.945。侵袭性念珠菌病者抗体阳性率为73.3% (44/60)，明显高于念珠菌定植者 27.5% (11/40)、烟曲霉菌感染者 10.0% (4/40)以及正常对照组 2.0% (2/100)，差异均有显著统计学意义(P<0.01)。血白细胞计数<4×109/L患者抗念珠菌烯醇化酶抗体检测阳性率明显低于白细胞计数为(4~10)×109/L和>10×109/L患者，差异均有统计学意义(P<0.05)。结论 双抗原夹心ELISA法对血清抗念珠菌烯醇化酶抗体诊断敏感性和特异性较高，并且有利于对疾病早期进行诊断，因此可以作为对侵袭性念珠病早期诊断的辅助工具。
      【关键词】 侵袭性念珠菌病；烯醇化酶；抗体；酶联免疫吸附法
      【中图分类号】 R379.4 【文献标识码】 A 【文章编号】 1003—6350（2018）13—1830—04

Determination of antibodies against enolase of Candida albicans by double-antigen sandwich ELISA.
WANG Jun,WU Fu-zhen, JIAO Ji-guang. Department of Clinical Laboratory, Shenzhen Baoan District Shiyan People's Hospital,Shenzhen 518100, Guangdong, CHINA
【Abstract】 Objective To investigate the detection effect of double-antigen sandwich enzyme-linked immuno-sorbent assay (ELISA) on the antibodies against enolase of Candida albicans. Methods A total of 140 patients (includ-ing 60 cases of invasive candidiasis, 40 cases of Candida colonization, 40 cases of Aspergillus fumigatus infection) con-firmed by clinical observation and laboratory blood culture were selected in Shenzhen Baoan District Shiyan People'sHospital from Jan. 2015 to Nov. 2017. Totally 100 individuals undergoing physical examination were enrolled as controlgroup. Double-antigen sandwich ELISA was used to detect antibodies against enolase of Candida albicans in blood.ROC curve was used to analyze the sensitivity, specificity and optimal predictive value of the method. Results TheROC curve showed that the area under the curve of the method was 0.861, and the best predictive value was 0.211, withthe diagnostic sensitivity, specificity, Youden index, 95% CI of 93.4%, 82.8%, 0.718, 0.722-0.945, respectively. The anti-body positive rate of invasive candidiasis was 73.3% (44/60), which was significantly higher than 27.5% (11/40) of Can-dida colonization, 10.0% (4/40) of Aspergillus fumigatus infection and 2.0% (2/100) of control group (P<0.01). The pos-itive rate of the antibody in patients with blood leukocyte count <4×109/L was significantly lower than that in patientswith white blood cell count of (4~10)×109/L and >10×109/L (P<0.05). Conclusion Double-antigen sandwich ELISAhas high sensitivity and specificity in the diagnosis of serum antibodies against enolase of Candida albicans, which ishelpful for early diagnosis of diseases. Therefore, it can be used as an auxiliary tool for early diagnosis of invasive can-didiasis.
      【Key words】 Invasive candidiasis; Enolase; Antibody; Enzyme-linked immunosorbent assay (ELISA)·论 著·doi:10.3969/j.issn.1003-6350.2018.13.017