التشخيص المخبري لليشمانيا الجلدية عند بعض المرضى في محافظة اللاذقية (خبرة مشفى الأسد الجامعي باللاذقية)
Abstract
شملت الدراسة الوبائية 294 مريضاً من المرضى المراجعين لقسم الأمراض الجلدية في مشفى الأسد الجامعي ومركز الليشمانيا في اللاذقية والذين شخصت لديهم الإصابة بالليشمانيا الجلدية سريريا" وذلك في الفترة الممتدة من شهر شباط وحتى شهر تموز من العام 2005 م.
وقد أجريت الدراسة المخبرية لعدد من هؤلاء المرضى وذلك باستخدام الفحص المجهري المباشر والتألق المناعي غير المباشر.
أجري الفحص المجهري المباشر على 100 مريض شخصت الإصابة عندهم سريريا " بالليشمانيا الجلدية, وكان عدد الآفات المفحوصة 247 آفة. وجاءت النتائج كما يلي:
- النتائج الإيجابية كانت بنسبة 73.68 %, بينما كانت النتائج السلبية بنسبة 26.32 %. حيث لوحظ أن النتائج الإيجابية كانت عالية بشكل مهم وبذلك يمكن اعتماد الفحص المجهري المباشر في التشخيص.
تمت دراسة 80 عينة مأخوذة من 80 مريضاً كل منهم عنده آفة ليشمانيا جلدية واحدة أو أكثر فعالة وغير معالجة وإيجابية بالفحص المجهري المباشر. وأجري عليها اختبار التألق المناعي غير المباشر حيث حصلنا على النتائج التالية: النتائج الإيجابية كانت بنسبة 58.75 %, والنتائج السلبية كانت بنسبة 41.25 % .
فوجدنا أنه بالإمكان الاستعانة بالتألق المناعي غير المباشر من أجل تشخيص الإصابة بالليشمانيا الجلدية وبحساسية 58.75 % .
ثم قمنا بمقارنة هذه النتائج مع دراسات سابقة موثقة, فتبين لنا أن الدراسة الحالية قريبة من الدراسات السابقة والتي تؤكد على أهمية الفحص المجهري المباشر والتألق المناعي غير المباشر في تشخيص داء الليشمانيا الجلدية.
This study was carried on 294 patients, who consulted the Department of Dermatology at Al-Assad University Hospital as well as the Leishmania Health Center in Lattakia. These patients were clinically diagnosed as leishmania infected between February and July 2005. Microscopic and indirect immunofluorescence tests were used on 100 patients, who were clinically diagnosed as skin leishmania infected. The number of studied lesions was 247. The results were as follows:
- The positive percentage was 73.68 %, while the negative percentage was 26.32%. It was found out that the positive results were very high; therefore, the direct microscopic diagnosis could be used.
We studied 80 samples taken from 80 patients infected with one or more skin lieshmanian lesions, which were active, untreated and positively diagnosed by a direct microscopic test. The samples were tested using indirect immunofluorescence tests and the following results came out:
- The positive percentage was 58.75%, the negative percentage was 41.25 %. We found out that we could use the indirect immunofluorescence tests to diagnose skin lieshmania infection with 58.75 % sensitivity.
We compared the results with those of previous documented studies, and we found out that our study was close to the previous ones. This emphasizes the important of the direct microscopic test and the indirect immunofluorecence test.
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