间接法和捕捉法检测特异性IgM的敏感性与特异性的比较

目的比较捕捉法和间接法检测IgM时的特异性和敏感度差异,并探讨其产生差异的原因。方法分别用间接ELISA法和捕捉ELISA法检测活动性乙型肝炎和肾综合征出血热(HFRS)患者标本的IgM水平,并比较两者之间检出率、检测阈值、特异性的差异。结果检测稀释在PBS中的鼠抗IgM特异性抗体,两种方法的特异性和敏感度类似;检测活动性乙型肝炎和HFRS患者标本,间接法检测IgM的敏感度明显低于捕捉法;检测经二巯基乙醇处理后乙肝组和HFRS组标本,两种检测均为阴性,表明两种方法都具有针对IgM抗体的型特异性;交叉实验结果证明两种检测IgM的试剂均具有针对抗原的特异性。结论急性感染疾病的早期诊断、病毒的潜伏期感染和慢性感染的再次激活应使用捕捉法检测IgM,间接法检测IgM用于急性感染性疾病的诊断有待进一步探讨。

Compar Bon of sensitivity and specificity of specific IgM detected by indirect-ELISA and capturing-ELISA

Objective To assess the differences in the specificity and the sensitivity in detecting specific IgM by indirect ELISA and capturing-ELISA methods,and to analyze the possible causes of those differences.Methods The HBc-IgM and EHF-IgM level in serum samples from activity Hepatitis B patients and hemorrhagic fever patients with renal syndrome were determined by both indirect-ELISA and capturing-ELISA methods,and the differences in the positive rate,positive threshold value and the specificity between those two methods were compared. Results Specific murine IgM diluted in PBS were detected by indirect-ELISA and capturing-ELISA,and the specificity and sensitivity of those two methods were similar.Results showed that sensitivity of indirect-ELISA was lower than capturing-ELISA in detecting specific IgM in serum from patients with activity Hepatitis B and hemorrhagic fever patients with renal syndrome.The IgM level in hepatitis B and hemorrhagic group treated with thioglycol became negative detected by those two methods,suggesting that both of them have the anti-IgM epitope-specificity.Cross reaction results demonstrated that the reagent detecting IgM from the two methods had the specificity to the specific antigen. Conclusion It is recommended to detect IgM level by capturing-ELISA method for the early diagnosis of acute infectious disease,pathological changes,immune reaction and prognoses of chronic continuous infectious disease.Applying the indirect-ELISA method to detect IgM level to diagnose acute infectious disease is to discuss in the future.