Diagnosis of herpes simplex virus encephalitis by the detection of intrathecal viral antigen with chemiluminescence assay.

本研究的目的是建立一种通过检测正常粒细胞中抗原-抗体复合体激活的补体刺激的化学发光来检测脑脊液中HSV抗原的技术。研究对象包括10例HSVE患者的17例脑脊液标本(其中10例来自6例病理和/或血清学确诊的HSVE患者，7例来自4例血清学可能的HSVE患者)，22例非HSVE、中枢神经系统炎症性疾病患者的26例脑脊液标本，30例非感染性神经系统疾病患者的30例脑脊液标本。用两种方法测定正常粒细胞的化学发光，一种是包括脑脊液(A)，另一种是包括脑脊液和抗HSV抗体(B)。化学发光的差异以每个样品的两个值的比率(B/A比)来评估。HSVE第5~38天采集的脑脊液B/A值均大于1.3，而非HSVE组均小于1.0。该方法只需5h即可得到结果。培养的HSV在对照脑脊液中稀释至10^0~10^6个感染单位。B法测定稀释样品的化学发光值。感染单位的公共对数与化学发光值之间存在统计学上的线性关系。该方法具有灵敏、特异、甚至定量的特点，是一种新的、有价值的、尤其是定量诊断HSVE鞘内HSV抗原的方法。

The purpose of this research is an establishment of a technique for detecting HSV antigen in cerebrospinal fluid(CSF) by measuring the antigen-antibody complex-activated complement-stimulated chemiluminescence in normal granulocytes. The materials consisted of 17 CSF samples from 10 patients with HSVE (10 from 6 pathologically and/or serologically definite HSVE,7 from 4 serologically probable HSVE), and 26 CSF samples from 22 patients with a non-HSVE,inflammatory disease of the central nervous system, and 30 CSF samples from 30 patients with non-infectious neurological diseases. The chemiluminescence of normal granulocytes was measured in two assays, one including CSF(assay A)and the other including CSF and anti-HSV antibody(assay B). The difference in chemiluminescence was evaluated as the ratio of the two values(B/A ratio)for each sample. The B/A ratios of all CSF samples taken from the 5th to 38th day of HSVE exceeded 1.3, while those for all non-HSVE were lower than 1.0. This assay required only 5 h to yield a result. Cultured HSV was diluted in a control CSF to a concentration of 10^0 to 10^6 infectious units. The chemiluminescence values of the diluted samples were measured in assay B.The relationship between the common logarithm of the infectious units and chemiluminescence values was statistically linear. This method represents a new valuable, especially quantitative and rapid diagnostic tool for intrathecal HSV antigen in HSVE ; it is sensitive, specific and even quantitative.