目的 比较循环抗原(circulating antigen,CAg )和特异性IgG4在脑囊尾蚴病诊断和生存状态、疗效评估中的价值.方法 依据CT和MRI的影像表现将68例脑囊尾蚴病患者分为活虫期、变性死亡早期、变性死亡后期及钙化期四个病期组,检测各病期患者血清中囊虫CAg和IgG4;分别对38例活虫期患者治疗前,治疗中,治疗后血清中CAg和特异性IgG4进行检测和比较分析.结果 不同病期患者血清CAg阳性率、IgG4阳性率差异均有显著意义.38例活虫期患者血清CAg、IgG4阳性率分别为100%和98%,随疗程进展,CAg、IgG4阳性率逐渐降低,不同疗程间CAg阳性率差别有显著性意义,而IgG4阳性率差异无统计学意义.结论 CAg和特异性IgG4能较客观地反映人体内脑囊尾蚴的生存状态,可作为早期诊断指标,两者的特异性及敏感性无显著差异;对远期疗效评估可以优先选用CAg.%The objective was to compare the potentials of circulating antigen and specific IgG4 in the diagnosis of cerebral cysticercosis, and understand the evaluation of living status and treatment efficiency.The 68 cerebral cysticercosis patients were divided into four different advanced groups according to CT and MRI manifestations.The CAg and the IgG4 in sera were detected for all patients.The 38 sera of patients with active cerebral cysticercosis were detected for CAg and IgG4 before, during and after treatment.The levels of CAg and IgG4 in sera of different groups have significant differences.For 38 patients of active cerebral cysticercosis, the CAg and the IgG4 positive rates were 100％ and 98％.With the increase of treatment courses,the positive rates decreased.The CAg levels in sera in different courses have significant difference, but those of the IgG4 have no great difference.The positive rate of the CAg and the specific IgG4 in sera of cerebral cysticercosis patients were coincident with the status of the cysticercus parasitized in the brain tissue of patients, and could reveal the living status of cysticercus in the brain.There was no significant difference of CAg and IgG4 for early diagnosis of cysticercus.But for treatment efficiency evaluation, the CAg was better than the IgG4.
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