THE PATHOPHYSIOLOGICAL ANALYSIS,EPIDEMIOLOGICAL INVESTIGATION AND THE ESTABLISHMENT OF THERAPY OF QFEVER USING INMUNOLOGICAL AND MOLECULARBIOLOGICAL EXAMINATION

巢式聚合酶链反应（PCR）用于直接种特异性检测贝氏柯克斯体的血液样本从58例慢性非特异性症状，随后在内科在日本大学板桥医院1996年4月至1998年12月。此外，还对在日本大学健康科学中心接受年度检查的67名健康对照者的单个血液样本进行了检查。根据岐阜大学的平井光一教授的编码外膜蛋白的贝氏隐孢子虫球茎1基因的核苷酸序列设计了用于巢式PCR的引物。58名患者中有19名（33%）通过巢式PCR显示出贝氏隐孢子虫感染的证据，94%的阳性患者报告与动物密切接触。相比之下，来自健康成人对照的67个样品中的5个（7.5%）。我们的研究结果显示，与健康对照组相比，患者中贝氏隐孢子虫感染的患病率较高。因此，Q热的存在， 关于我们 在出现非特异性症状的情况下，必须考虑人畜共患病，特别是那些与动物密切接触的人。此外，我们发现短期米诺环素治疗，以改善这些非特异性症状，在许多PCR阳性患者。他们中的一些人谁改善米诺环素成为阴性的贝氏隐孢子虫DNA通过PCR与改善这些症状。必须考虑长期治疗和进一步研究。贝氏隐孢子虫感染在非特异性症状中的可能作用仍有待阐明。此外，在日本大学板桥医院和一家私人诊所分娩后立即采集的70份脐带血样本进行了检测。几乎所有的脐带血样本（97%）是阴性的伯氏梭菌。据我们所知，这是第一次使用PCR检测脐带血样本中的贝氏隐孢子虫。我们的研究结果支持了人类贝氏隐孢子虫感染是获得性的概念，并为调查是否通过感染产妇的胎盘发生垂直感染提供了理论基础。少

The nested polymerase chain reaction (PCR) was used for direct species-specific detection of Coxiella burnetii in blood samples from 58 patients with chronic nonspecific symptoms followed at the departments of internal medicine in Nihon University Itabashi hospital between April 1996 and December 1998. Single blood samples, obtained from 67 healthy controls who had received annual examinations at the Nihon University Health Science Center, were also examined. Amprimers for nested PCR were designed from the nucleotide sequence of the C.burnetii corm 1 gene encoding outer membrane protein by Prof. K.Hirai of Gifu University. Nineteen (33 %) of 58 patients showed evidence of C.burnetii infection by nested PCR, and 94 % of positive patients reported close contact with animals. In contrast, five (7.5 %) of 67 samples from healthy adult controls. Our results show a high prevalence of C.burnetii infection among patients as compared with healthy controls. Therfore, the existence of Q fever as … More a zoonosis must be considered in cases with nonspecific symptoms, especially those living in close contact with animals. Furthermore, we have found short term treatment with minocycline to improve these nonspecific symptoms in many PCR positive patients. Some of them who improved on minocycline became negative for C.burnetii DNA by PCR with improving these symptoms. Long term treatment and further study must be considered. The possible role of C.burnetii infection in nonspecific symptoms remains to be elucidated. Furthermore, 70 cord blood samples taken immediately after delivery in Nihon University Itabashi hospital and one private clinic, were tested. Nearly all cord blood samples (97 %) were negative for C.burnetii. To our knowledge, these are the first tests of cord blood samples for C.burnetii employing PCR.Our findings support the concept that human C.burnetii infection is acquired and provide a rationale for investigating whether vertical infection occurs through the placenta of infected parturient woman. Less