Utility of a commercial immunoblot kit (BAG-Borrelia blot) in the diagnosis of the preliminary stages of Lyme disease
Utility of a commercial immunoblot kit (BAG-Borrelia blot) in the diagnosis of the preliminary stages of Lyme disease
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DOI：
10.1016/s0732-8893(03)00111-1
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发表时间：
2003-09-01
影响因子：
2.9
通讯作者：
Rodríguez-Torres, A
中科院分区：
文献类型：
--
作者：
Hernández-Novoa, B;Orduña, A;Rodríguez-Torres, A
本研究的目的是评估商业免疫印迹（IgG和IgM BAG-Borrelia印迹）在莱姆病早期血清学诊断中的实用性。共研究了42例莱姆病患者（24例局限性早期（LES）和18例播散性早期（DES））和129例非莱姆病患者（特异性对照血清）的血清。来自伯氏疏螺旋体s.l.的IgG抗p41抗p41/IPBi（16.7%）、抗p100（9.5%）和抗OspA（9.5%）。IgM抗p41抗体阳性率为66.7%，p41/iPBi阳性率为54.8%，OspC阳性率为33.3%。抗p100、OspA和OspC的IgM在DES组的检出率（16.7%、27.8%和44.4%）高于LES组（0.0%、4.2%和25.0%）。在4.8%的情况下，没有IgG带，在26.2%的情况下，没有IgM带。除孤立的p41条带（59.5%）外，没有条带模式超过17%。使用厂家说明书，试验诊断早期莱姆病的敏感性为61.9%，特异性为98.4%，阳性和阴性预测值分别为92.8%和88.8%。应用EUCALB 5、6或7规则，敏感性增加到73.8%，但特异性降低到89.9%。在129份特异性对照血清中，41.8%呈现IgG抗p41，10.8%呈现IgM抗p41。非莱姆病患者中IgG、IgM阳性率较高的依次为梅毒患者（88.2%）、抗HIV抗体阳性者（57.8%）和抗核抗体阳性者（52.3%）。(C)2003年爱思唯尔公司All rights reserved.
The aim of this study was to evaluate the usefulness of a commercial immunoblot (IgG and IgM BAG-Borrelia blot) in the serologic diagnosis of the early stages of Lyme disease. A total of 42 sera from patients with Lyme disease (24 patients with localized early stage (LES) and 18 patients with disseminated early stage (DES)) and 129 sera from patients with non-Lyme diseases (specificity control sera) were studied. IgG anti-p41 from Borrelia burgdorferi s.l. was present in 95.2% of patients followed by anti-p41/I PBi (16.7%), anti-p100 (9.5%) and anti-OspA (9.5%). IgM anti-p41 was present in 66.7% of patients, p41/iPBi (54.8%) and OspC (33.3%). IgM against p100, OspA and OspC were more frequent in DES patients (16.7%, 27.8% and 44.4%) than in LES patients (0.0%, 4.2% and 25.0%). In 4.8% of the cases no IgG bands were present and in 26.2% no IgM bands were present. With the exception of isolated p41 bands (59.5%), no band pattern exceeded 17%. Using manufacturer's instructions, test sensitivity in diagnosis of the early stage of Lyme disease is 61.9%, specificity 98.4% and positive and negative predictive values 92.8% and 88.8% respectively. Applying the EUCALB 5, 6 or 7 rules sensitivity increased to 73.8% although specificity decreased to 89.9%. Of the 129 specific control sera, 41.8% presented IgG anti-p41 and 10.8% IgM anti-p41. Patients with non-Lyme diseases that presented more IgG and IgM bands were those patients with syphilis (88.2%), patients with anti-HIV antibodies (57.8%) and patients with anti-nuclear antibodies (ANA) (52.3%). (C) 2003 Elsevier Inc. All rights reserved.