董太明 黄震东 吴红穗 陈剑光 陈志红 罗健 510100 广州，广东省人民医院 中华儿科杂志 1998 0 36 3


    关键词：链球菌；酿脓；链球菌感染；风湿热；肾小球肾炎；脱氧核糖核酸酶 期刊 zhekzz 0 论著 fur -->


    

【摘要】 目的 探索抗DNA酶B测定A组溶血性链球菌(GAS)感染血清学方法的诊断价值。方法 用抗DNA酶B微量法和自制试剂，测定548例GAS感染所致疾病的小儿血清抗DNA酶B抗体，同时测定抗链球菌溶血素O(ASO)。 结果 (1)急性风湿热组(ARF)抗DNA酶B阳性率(72.5%)与ASO阳性率(76.5%)比较，差异无显著意义(P>0.05)；但活动期风湿性心脏病(简称风心病)组病人的抗DNA酶B阳性率(82.6%)明显超过ASO阳性率(55.4%)(P<0.001)；抗DNA酶B联合ASO测定在两组的阳性率均在90%左右。(2)急性肾小球肾炎(AGN)皮损组抗DNA酶B阳性率92.6%，明显超过ASO的59.2%(P<0.05)。(3)AGN上感组抗DNA酶B与ASO的阳性率分别为76.7%和73.9%(P>0.05)。抗DNA酶B联合ASO的阳性率在上感组和皮损组均超过90%。结论 抗DNA酶B在诊断ARF和AGN方面具有重要的临床价值，特别与ASO联合应用价值更大；对活动期风心病和GAS皮肤感染致AGN的诊断价值明显优于ASO。

Anti-DNase Bmicrotitration in the diagnosis of group A streptococcal infection in pediatrics

Dong Taiming, Huang Zhendong, Wu Hongsui, et al.

Rheumatic Fever Laboratory, GuangdongProvincial Cardiovascular Disease Institute, Guangzhou 510100

【Abstract】 Objective To evaluatediagnostic value of anti-DNase B microtitration in group A streptococcal (GAS) infection. Methods Anti-DNase Bantibodies of 548 children with GAS infection were detected with anti-DNase B test.Antistreptolysin “O” (ASO) was simultaneously measured. Results (1) No significantdifference was observed between positive rate of anti-DNase B (72.5%) and ASO (76.5%) inacute rheumatic fever (ARF) group (P>0.05). However, the positive rate of anti-DNase B(82.6%) was significantly higher than that of ASO (55.4%) in acute rheumatic heart disease (ARHD) group (P<0.001). When the anti-DNase B test was studied simultaneously with theASO test, the number of sera with elevated titers in at least one test increased to about90% in ARF and ARHD groups; (2) The positive rate of anti-DNase B test (92.6%) wasobviously higher than that of ASO (59.2%) in pyoderma subgroup of acute glomerulonephritis (ANG) cases (P<0.05). However, there was no significant difference between anti-DNase Bpositive rate (76.7%) and ASO (73.9%) in upper respiratory tract infection subgroup ofsuch cases (P>0.05). The positive rate exceeded 90% when anti-DNase B was used togetherwith ASO in AGN group. Conclusion Anti-DNase B microtitration test may be an useful tool in thediagnosis of ARF and AGV. The positive rate of anti-DNase B test was higher than that ofASO in patients with ARHD and those with AGN with underlying skin infection.

     【Key words】 【Key words】 Streptococcus, pyogenes Streptococcalinfections Rheumatic fever Glomerulonephritis Deoxyribonucleases

我国目前A组溶血性链球菌(GAS)感染检测的血清学方法仅有抗链球菌溶血素O(ASO) ......