摘要
目的检测单眼牵引性视网膜脱离患儿房水与血清中犬弓蛔虫特异性IgG抗体,探究单眼牵引性视网膜脱离患儿眼弓蛔虫病的发病率。方法选取2015-2017年就诊于上海新华医院眼科单眼牵引性视网膜脱离的患儿42例为研究对象(试验组),另取20例确诊患者为阳性对照。收集血清及患侧房水样本,用ELISA试剂盒检测所有样本中犬弓蛔虫特异性IgG抗体。比较试验组与对照组抗体效价的差异,同时比较试验阳性组与阴性组临床资料的差异,并计算血清特异性抗体检测在诊断眼弓蛔虫病中的灵敏度及特异度。结果 42例患儿中有25例(59. 5%)是由眼弓蛔虫病导致的牵引性视网膜脱离,25例患儿与另外17例相比,性别比例、年龄分布、临床表现均无特异性改变。表现为牵引性视网膜脱离的眼弓蛔虫病与阳性对照组相比,血清阳性率和房水效价值均无明显差异。血清检测诊断眼弓蛔虫病的灵敏度为76. 0%,特异度为88. 2%。结论单眼牵引性视网膜脱离患儿中,眼弓蛔虫病所致的牵引性视网膜脱离患儿占59. 5%,单从临床表现无法区分,房水特异性IgG抗体检测可确诊。
Objective To investigate the incidence rate of ocular toxocariasis (OT)in children with unilateral tractive retinal detachment by detecting the toxocaracanis specific antibody(T-IgG) of the patients' aqueous and serum. Methods Totally 42 pediatric patients with monocular traction retinal detachment who came to Shanghai Xinhua Hospital between 2015 and 2017 were selected as study subjects (experimental group),and another 20 patients who were confirmed as OT were selected as positive controls. All the patients were tested for T-IgG in the peripheral blood and aqueous samples by enzyme-linked immunosorbent assay. The differences of antibody titers between the experimental group and the positive control group were compared, and the differences of clinical data between the positive control group and the experimental group were also compared. The sensitivity and specificity of serum specific antibody detection in the diagnosis of OT were calculated. Results In the total 42 patients, 25 of them(59.5%) were OT caused by tractive retinal detachment, and they had no specific difference in gender ratio, age distribution and clinical manifestations with the other 17 patients. Compared with the positive control group,the 25 patients had no significant difference in the serum positive rate and the value of T-IgG. The sensitivity and specificity of serum test in diagnosis of OT was 76.0% and 88.2%, respectively. Conclusion The rate of OT in children with unilateral tractive retinal detachment is 59.5%. They can't be clearly diagnosed by clinical presentation alone, but T-IgG test can help to determine the diagnosis.
引文
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