^4 ^ r -ì 'n ( _ V i :-_ i i\u ié^* ,.1fV '-v ^ •V'S V •••''V.'- ,• *f i; ^ %• J^~ - Wv?c.V{^ '- -t^^>• * ^ ' l ' ^ - ^ ^ - j : : ' :>C C S V^^' >^:% f V - •.'^^*- - M^'r^ , '• , -*»JK t*^- ( >.j v\l^ V -A > BO CIAO DUC VA DAO TAO TOUONG DAI HOC TONO HOF HÀ NÓI *=!:* Lai Minh Hién ^? mm V^ l'i/Q^ NGHIÉN CLfU LfNG DUNG CÀC PHUONG PHÀP HUYÉT THANH HOC DÙNG TRONG CHAN DỒN BÉNH SĨT Q DO Coxiella burnetii CHUYEN NGÀMH : V! 5INH WOC MA s6 :1.05.12 LUAN AN PHO TIEN SI KHOA HOC SINII HOC c o VAN KìlOAFipC: POS ITS PIIAM VÀN1\ PPS VVQUAWGIJIA' \'^nM\ iik;^*L a: HANOI " 1995 MUC LUC Trang - Dat vàn de - Tóng quan tài Uéu — 2.1 - Lugc sur nghièn culi sò't Q 2.2 - Dac diém sinh hoc cùa màm bènh 2.2.1 - Dac diém hình thài va tinh chà't ni cà^ 2.2.1.1 - Dac diém hình thài ' 10 2.2.1,2-Tinh bàtmàu 12 2.2.1.3 - Tinh chà't nuòi cày Coxiella 13 2.2.2 -Dac diém mièn dich hoc 2.2.2.1 - Càu trùc khàng nguyèn cùa C.bumetu 21 2.2.2.2 -Dac diém mièn dich hoc 27 2.2.3 - Tinh de khàng 29 2.3 - Chin doàn phòng nghiém 32 2.3.1 - Phàn làp màm bénh 32 2.3.2 - Phucfng phàp huyè't hoc 33 - Vàt héu va phuang phàp 3.1 - Vàtliéu 44 3.2-Phucrng phàp 45' 3.2.1 - Diéu che'khàng nguyèn 45 3.2.2 - Diéu che"khàng thè' dac hiéu 46 3.2.3 - Diéu chè'hóng càu gàn khàng nguyèn C.bumetii dùng ngimg kè't hóng càu thu dòng 47 3.2.4 - Diéu che"càc còng hop 51 3.2.4.1 - Diéu che" còng hop khàng thè' gàn FITC 51 3.2.4.2 - Diéu che"còng hgrp khàng thè' gàn POD 53 3.2.5 - Phucmg phàp khuéch tàn trèn thach 55 3.2.6 - Phuomg phàp mièn dich dién di doi lini 56 3.2.7 - Càc phucmg phàp khàc 57 - Kè"t qua va bàn luàn • 59 4.1 - Cày trun C.bumetii long dò phói gà 59 4.2 - Diéu che'va kiè'm tra boat tinh KN 63 4.3 - Diéu che" huyè"t mièn dich 68 4.3.1 - Kè"t qua diéu che'dich bang mièn dich 68 ^— A32 - Diéu chè'huyét mièn dich thò 68 4.4 - Diéu che" còng hop khàng thè' gàn FITC va POD 71 4.4.1 - Diéu che" còng hgp khàng thè' gàn FITC va POD 72 4.4.2 - Dành già chà"t lirong còng hop FITC va POD 4.4.3 - Nghièn cuti su phàt trién cùa C.bumetii tè'bào dich bang Eurhch bang KTHQ va KT enzim 75 4.5 - Kè"t qua diéu che'hóng càu gàn KN C.bumetii phàn ùng NKHCro 80 4.5.1 - Ành hucfng cùa càc chà"t xù ly hóng càu dè"n qua trình gàn 80 4.5.2 - Ành huomg cùa nóng dò KN C.bumetii dè'n qua trình _gàn 81 4.5.3 - Xàc dinh dò nhày va tinh dac hièu cùa chè'ph£m ch^n dồn 4.5.4 - Tnòi han bào quàn cùa chè'phàm chàn doàn 82 83 4.5.5 - Kiém tra mùc dò gàn khàng nguyèn C.bumetu lèn bé mat hóng càu bang KTHQ va KT enzim 84 4.6 - Xàc dinh KT dac hièu vód C.bumetii bang càc phucfng phàp huyét hoc 4.6.1 - Xàc dinh KT bang NKHCTO 88 4.6.2 - Xàc dinh KT bang MDDDDL 89 4.6.3 - Xàc dinh KT bang KTTT 89 4.7 - Diéu tra khàng thè Imi hành khàng C.bumetii huyét nguòi 92 - Kè"t luàn 100 - Tài Uéu tham khào ^Q2 NHCNG CH0 VIET TAT KHBT : Kèt hop bò thè Khàng thè huynh quang KTHQ Kl'iT Khuèch tàn trèn thach : Khàng nguyèn KN KT : Khàng thè' EUSA : Hà"p thu mièn dich co gàn enzim RIA : Mièn dich phóng xa FITC : Fluorescein isothiocyanat POD : Peroxidaza MDDDDL : Mièn dich dién di ddi luu NKHCTD : Ngung kèt hóng càu thu dòng irCNKHCTD : Ùc che ngung kèt hóng càu thu dòng LPS : Lipopolisacarit UCNKHC : Uc che" ngung két hóng càu I - DÀT VAN DE Sot Q Coxiella burnetii gay khong phài bénh nhiém trùng bien co ty le mac cao, song mot bénh truyen nhièm càn dilòc quan tàm dùng mùc nhtìng dac diém sau: Là mot bénh lày nhiém phàn bò' trén tồn the' giòi, ké cà mot so' niióc can vói Viet Nam nhif Trung Quò'c, N h a t Bàn, Malaixia, An Do (32, 87, 112, 120, 152, 157) Bénh lày truyén qua nhiéu duòng khàc n h a u nhil diiòng tiéu hoà, màu, trùng trung gian va dac biet qua dng ho hap dilói dang dung co khà nàng gay bénh cho nhiéu ngilòi mot tliòi gian ngan va lan truyén di r a t xa (42, 112, 152) Màm bénh sot Q, khàc v6i nhiéu loai Rickettsia khàc, co sue de khàng cao va co doc \\Lc m a n h (109, 112, 152) Bénh cành làm sàng cùa nhiém C.bumetii r a t da dang, khòng the hồc rat khó chuan dồn xàc dinh bénh bang * càc bieu hién làm sàng, hon ntìa co nhitng the bénh dién bién nang dàn den tu vong (32, 112, 160, 157, 163, 174) •2 Mam bénh sot Q co the dUdc su dung làm vù sinh vàt chién tranh sinh hoc (112, 152) Càc tài liéu nghièn cùu ve bénh sot Q rat it òi ò nxiàc ta Tuy nhién, càc so' liéu cong bò' thày bénh co lifu h n h ò ngxlòi va dòng vàt nuòi tai Viet Nam (5, 112, 119, 120) Do vay tièp tue nghièn cùu diéu tra bénh càn thiét De giài quyé't vàn de này, chùng ta càn co diltìc càc phiidng tien, bao gom sinh pham chan doàn, svi hoàn thien càc phiidng phàp de thUc hién càc xét nghiém phòng thi nghiém Y thùc diiòc nhtìng vàn de:, trén de tài nghièn cùu cùa chùn^ tòi n h m càc muc tiéu sau: Diéu che' so' che' pham sinh hoc dùng chan dồn sò't Q Dành già chat IvLóng càc sinh pham che" tao va luta choh phiidng phàp thìch hòp de xàc dinh m m bénh, xàc dinh KN, KT Ung dung càc che phàm va phiidng phàp dà nghièn cùu dtfdc de bifòc dàu diéu tra so' nguòi co k h n g C.bumetii the .3 •a .Ci • •CP H: "5 ri •I-4 i' HO P ' o ":'"H :/ì P*: : :Sr- vivC::::; :;:^:;:;:;pf:;: Ti cac ph • -• t - M H Đ 7^ ^ 5r fi m •0 • • * 2: 05 o o>, o X a- X gi pr^ o o rs g rtằo ô: >;- C/5;; o r o> P^ S SS xa •p 'K ^ liii 25 n * o a> H a T e* «• 3;; - TĨNG QUAN TÀI LIÈU J - LUDC SlTNGHIÈN c ù u SOT Q Bénh sóì Q Rickettsia, dàu tién durgfc Derrick xàc dinh ve mat làm sàng ò Uc (mien nam Queensland) nàm 1937, nhimg tnxòc dò, nàm 1935 tàc già dà phàl hién ihà'y càc trirìnig hop bénh tircfng tu ò Brisben (trong so càc còng nhàn xi nghiép bào quàn thit), vi vày tàc già goi bénh sot "Q" ("Q" tijr tiéhg Anh "Querf nghTa chua xàc dinh) (29) CQng nàm 1937 Derrick dà phàn làp trén chuol lang duttc so' màu màu bénh nhàn bi bénh vimt ma Bumcl va Frecman xé'p vào Rickettsia dang qua loc Nàm 1939 Deirick goi mam bénh tìm dirofc "Rickettsia humetif (30) Cuoi nàm 1942 càc nhà nghièn curu Uc dà làp lai thi nghiém gay nhiém bé va v'é màt huyét hoc dà xàc dinh d\xac su' co mat cùa bénh nhiém trùng dà mó tà truac Trén ca so càc nghièn ciai cùa càc tàc già Ùc, nguòfi ta dà di dèh già thiét bò màc bénh sò't Q qua ve bj nhièm Nguòi bi nhiém bénh qua ve va dac bièt hit phài bui co chira phàn ve hồc tié'p xùc vai bò bi bénh qua vé't xc Nói chung bénh thucmg gap a nòng dàn va còng nhàn lo mó De)c làp vai càc nhà nghièn cùu nguòi Uc, a My vào nàm 1938 Davis va Cox dà phàn làp duac lù ve mot loai virut qua loc, sau dò Cox xàc dinh Rickettsiavh dat tén "Rickettsia diapotica" (27) Nàm 1938 tai Hoc vién y khoa Washington (My), Dyer xàc dinh rang chuòt lang dà truyen bénh Dira trén làm sàng va dich té hoc, Dyer dà xàc dinh su giòng giùa nói Uc R.bumetii cùo Deirick nàm 1939 va ActaVu"oL,797S, 3, 309-315 50-Kazar J X ' a l y s ^ m l ' ' ' T^^T^ ' " ' i-munoglobulins in sera of rabbits and guinea pigs immunized with Coxiella bumeth Acta Virol , 7977, 2, 246-255 51 - Kalvatchev Z N., Bonteheva R, V andAlexand rov E G Dot ; ELISA for rapid detection of Q fever and spotted fever group antmckettsial antibodies ActaviroL , 9 , , 52 - Klopstock A., klopstoek E and Rozenkranz G The first diagnosed outbreak of Q fever in Israel Trop Dis BuU., 1949, 46, 11 53 - Kordova N and Brezina R Multiphcation dynamics of phase I and II C.bumetii in different ceU cultures Acta virol , 1963, 7, 84-87 54 -Kordova N Some results of a study of C.bumeth in tissue cultures Zhur MicrobioL , 795S, 104, 220-224 55 - Kordova N Histochemical and fluorescent antibody studies on the early stages of infection of L ceUs with C.bumetii Zhar, MicrobioL , 1968 56 - Kulagin S M and Kekeheeva N G * Study of Q fever in the U S S R Zhur Mikrobiol Epidemiol Immunobiol., 1954, 57 - Lennette E H., Bean B H., Abinati F R., Burnet O and Covert J M Serological survey of sheep, goats and catUe in three epidemiologie categories Am J Hyg , 7957, 54, 1-14 58 - Lerner A M and Lauter C B Passive hemagglutinating antibodies in cerebrospinal fluids in Herpesvirus hominis encephalitis Proceed Society for Exper Biol and Med , 7972, 4, 1460-1466 59 - Lillie R B., Perrin T L and Armstrong C An institutional outbreak of pneumonitis 108 Z Q ' ^ e T e f ' ' ' ' ' ' ^ "^'^ ' " ' " ' " ^ "^"^^y^ - ^he pneumonitis due to Pub Health Rep 1941,56, 149-155 60 - Marmion B P and Harlay M S ^ e j ^ a i y i n g epidemiology of Q "feCer in the South East region of Great J- Hyg., 7955, 54, 6\ - Miller M H An improved immunoperoxidase technique for identifying SV 40V and T antigens by light microscopy Proceed SocieL for Exper Biol and Med 7974,146,432-437 62 - Novak M., Brezina R and Kazar J Immunoblot analysis of antibody response in mice infected with C.bumetii phase L ActaviroL ,7992, 1,39-44, 63-Oda H andYoshiieK Application of trichloroacetic acid - treated antigen for serodiagnosis of fever by indirect immunoflurescence technique Kansenshogaku Zasshi, 7997, 10, 1281-1285 64 - Ormabee R A., Bell E J and Laekman B B Antigens of C.bumetii I Extraction of antigens with non aqueous organic solvents J ImmunoL , 1962, 88, 741-749 65 - Parker R R and Steinhans E A American and Austrahan Q fevers Persistence of the infectious agents in guinea - pigs tissues after defervesccnce Pub Health Rep , 1943, 58, 523-527 66 - Paseual V F Otero F I and Borohio E M Prevalence of antibodies against CoxieUa bumeth in a healthy population in Lanzarote (Canary Island s) An Med hitema , 7997, 5, 223-233, 67 - Payzin and Golem S The presence of Q fever in Turkey Trop Dis BuU , 794«, 45, 10 68 - Peacock M, G Antibody response in man foUowing a smaU intradermal inoculation with C.bumetii phase I vaccine ActaViroL,7979, 3, 73-81 109 69 - Peter O., Dupuis G., Burgdorfer W and Peacock M Evaluation of the complement fixation and direct immunofluorescence test in the early diagnosis of primary Q fever EUr J Clin Microbiol., 1985, 4, 394-396 70 - Peter O , Dupuis G , Bee D , Luthy R , Nicolet J and Burgdorger W Enzyme - linked - immunosorbent assay for diagnosis of chronic Q fever J Clin Microbiol , 1988, 10, 1978-1982 lì-Philip C.B Comments on the name of the Q fever organism Pub Health Rep., 1948, 63, 58 72 - Pickens E G and Gaon J A Growth of C.bumetii in agar tissue culture Am J Trop Med , 1961, 10, 49-51 73 - Ponomareva T J A stable antibody-sensitized eryhorocyte diagnostic preparation for detection of Rhinovirus typ 17 and its antibody Acta virol , 1976, 20, 232-237 74 - Pospisil V F Persistent infection of celi cultures with C.bumetii Acta virol , 1966, 10, 542-548 75 - Radulovic S., Speed R., Feng H M., Taylor C and Walker D H EIA with species-specific monoclonal antibodies : anovel seroepidemiologic tool for determination of the etiologic agent of spotted fever Rickettsiosis J Infect Dis., 1993, 5, 1292-1295 76 - Reed C F Q - fever surveUlance in Ohio Amer J of Epidemiol , ÌP65, 2, 234-236 77 - Robbins F C , Gauld R L and Wamer F B Q fever in the Mediterranean area II Epidemiology Am J Hyg., 1946,44,23-30 78 - Sadecky E Vaccination of naturally infected ewes against Q fever Acta virol , 1977, 6, 89-92 79 - Sadecky E Immunization against Q-fever of naturally infected Dairy cows Acta vkology, 1975, 19, 486-488 %0 - Schramek S ^^° 81 - Schramek S Influence of mild acid hvdrolvsis on tu^ ,• • • Cbumetii nyaroiysis on the antigenic properties of phase I Acta virol, 1978, 5, 302-308 82 - Schramek S Isolation of endotoxic lipopolysaccharid-from phase II C.bumetii Acta virol , 1979, 8, 349-352 83 - Schmeer N., Krauss H., Werth D and Schiefer H G Serodiagnosis of Q fever by enzyme-linked-immunosorbent assay (ELISA) Zentralbl Bacteriol Microbiol Hyg , 1978, 1, 57-63 U-SerhezovV andAlexand rov E Detection an identification of C.bumetii and R.conorii using the direct and indirect immunoperoxidase techniques MU Med Inst 7950 85 - Shepard C C and Huebner R J Q fever in los Angeles Country ; description of some of its epidemiclogical features Am J Pub Health, iP^S, 38, 781-788 86 - Siegel M M., Scott McNair T F., Henle W and Janton O H Q fever in a wool and hair processing plant Am J Pub Health, 1950, 40, 524-532 87 - Soenner H G A manual of tropical medicine Philadehphia London, 1989 88 - Syrucek L Isolation of C.bumetii from human placentas J Hyg Epidemiol Microbioh., i95«, 11, 29-32 89 - Taylor R M., Kingston J R and Rizk F Serological (complement - fixation) survey for Q fever in Egypt and Sudan, with special reference to its epidemiology ùi areas of high endemicity Arch Inst Pasteur Tunis, 1959, 36, 529-556 90 - Thiele D., Karo M., and Krauss H Monoclonal antibody based capture ELISA/ELIFA for detection of C.bumetu in clinical specimens Eur J Epidemiol., 1992, 4, 568-574 Ili 91 - Thiele D., Willems H and Krauss H New possiblities for the diagnosis of Q fever and for the differentiation of the causative agent Beri Munch Tierarztl Wochenschr , 1992, 2, 45-49 92 - Tiscione E , Ademollo B., Donato R., Roller S and Signorini L F Prevalence of antibodies against C.bumetii in geographical zone Ann Ig., iPS9, 5, 1133-1143 93 - Tokasevich N K Determination of immunogrosulin classcs of antibodies againts C.bumetii by protein a from Staph.aureus Acta virol , 1980, 24, 218-221 94 - Tokuda G Detection of Foot-and -Mouth disease virus antibodies I "Passive" hemagglutination test Appi, microbiology, 1970, 1, 35-39 95 - Urvolgyi J Sedimentation of phase II C.bumetii strains in C2C1 density gradient Acta virol , 1976, 20, 263-265 96 - Urvolgyi J Preparing and straining of C.bumetii naturai phase II for the microagglutination reaction Acta virol , 1976, 20, 238-242 97 - Urvolgyi J Erythrocyte - sensitizing substance fromR Canada A d a virol , 7975, 19, 255-257 98 - Wilson G S Preventive medicine and public Health New York, 7956 (297-298) 99 - Williams J C , Peacock M G , Waag D M , Kent G , England M / , Nelson G and Stephenson E H Vaccines against Coxiellosis an Q fever Development of a chloroformmethanol residue subnit of phase I C.bumetii for the immunization of animals Ann N Y Acad Sci , 7992, 653, 88-111 100 - Williams J C., Peacock M G and Race R E Immunization of dogs with Q fever vaccines : Comparison of phase I, II and phase I CMR Coxiella bumetii vaccines Rev Elev med vet pays Trop , 1993, 46, 87-94 112 101 - Wojeiechowski E The problem of Q fever in Polen BuU Inst Mar med Gdansk, 7959 10 39-47 102 - Wyatt G R and Cohen S ' Nucleic acids of rickettsia Nature, London, 7952, 170, 846-847 103 - Zdrodowski P F and Golinevich E H The rickettsial diseases 1960, Londres, Pergamon, ed TIÉNG PHÀP 104 - Babudieri B, et Secchi P Techniques de laboratoire pour le diagnostic de la fievre Q Monographie de l'O M S F A O , zoonoses, paris, 7954, Masson et Gie, ed, 218-228 105 - Baudon B et Gateffe Methods statistique de base pour medicins isolés paris, 1989, 29-42 106 - Blanc G Epidemiologie de la Q fever (CoxieUose) Maroc med , 1954, 33, 354 107 - Blanc G , Ascoine L et Bésiat P, Rickettsémie experimental de Testudo mauritanica avec R bumetii et infection dela tique hyalomma acgyptium BuU Soe path exot., 7959, 52, 564-567 108 - Caminopelros J La bronchop neumonie épidemique hivemo printannière humaine et animale (Chèvre, mouton); fièvre Q ou grippe de Balkàn R bumetii "Var caprine"; les caractères particuliers de l'infection animale Ann Ist Pasteur, 7949, 77, 750-757 109 - Combieseo B Fièvre Q (typhus pulmonaire, rickettsiose pulmonaire) Arch roun path exper microbiol , 7957, 16, 37-55 110 - Fonseca F,, Finto M., Azevedo J., Costo-Amaro F et Laeerda M Febre Q em Portugal Clin contemp , 1949, 3, 21-27 111 - Garin J Q fever au Maroc Enquéte épidémiologique au Tafilalet BuU Inst Hyg , Maroc, 7957, 2, 185-206 113 112 - Giroud P et Capponi M, La fièvre Q ou maladie de Derrick et Burnet F 1966 113 - Giroud P et Gouton M Maladie de Derrick et Burnet ou "fièvre Q" étude cUnique et épidémiologique Semaine hòp Paris, 7953, 29, 699-707 114 - Jadin J., Thomas J et Léonard J Fréquence des anticorps agglutinat R bumetii dans 1' asvortement des bovidés en Belgique C R Soc bioL , Paris, 7959, 153, 1881-1882 115 - Maurin J Recherches sur l'existence de la fièvre Q en Tunisie Ann Inst Pasteur, 1954, 86, 69 \\6-Penso G Epidemiologie de la fièvre Q en Italie BuU Soc path exot., 1963, 56, 607-619 ni -Finto M.R Le diagnostic de laboratoire de la fièvre Q et le problème de la variation antigénique de C bumetii BuU Soc path exot., 1963, 56, 643-654 n%-Pruda de J La fiebre Q en Espana Med Colon , 1949, 14, 471-496 119 - Quintin, Besnues etAutran Note sur 25 cas de fière Q observés bord de certain navires de la Marine Nationale Saigon Rev med nav , 7957, 12, 7-27 no-Raoult B La fièvre Q : infection CoxieUa bumetii Encycl Med Chir (Paris - France), Maladies infectieuses., 1988, %G11 N"l,3 TIÉNG D i r e 121 -BielingR Die Balkangrippe Das Q fieber der Alten Welt Beitr Hyg Epidemiol., 1950, 114 \22-BoerrH W und Heferer E Epidemiodogische und klinische Erfahmngen anlafiUch einer Q-Fieber Epidemie in Herbst 1978 in Norbaden Bundesgesundheitsbl , 1980, ^ 123-FriemelH Microbiologische Arbeits methoden Jena , 1980 124 - Kazimierz K Die serologische Untersuchungen bei dem ersten Q - Fieberfokus in Polen J Hug Epidemiol Mikrobiol Immunobiol 795«, 11, 148-152 125 - Kóhler W und Mochmann 77 Grundrip der Medicinischen Milrobiologic Jena, 1968, 456-457 126 - Kraus H und Sehmatz H B Seroepidemiologische Untersuchengen liber Rickettsien Infectionen bei Haustieren in Agypten, Somalia und Jordanien Trop parasitoL , 7977, 2, 285-288 m -BechtH Untersuchungen ùber die Biosynthese und ùber den serologischen Nachweis des Ribonucleo proteid - Antigenes von Influenzaviren Med Microbiol ImmunoL , 7977, 156, 331-337 128 - Herrmann B., Hermann H Vergleichende Untersuchungen ùber den Nachweis von Adenoviren in Zellkulturen mir Fluoro chrem-und Enzym - markierten Antikòrpem Zbl Bakt Hyg , 7973, A224, 273-284 \29 - Liebisch A Die isolierung von C bumetii ans Dermacsutor marginatns (Ixodidac) in Naturherden des Q-Fiebers in Suddeutschlund Trop Med und ParasitoL , 7972, 2, 285-287 UO-RaskaK und Syrucek L, Ein Beitrag zur Epidemiologie der Q-Rickettsiose Zentralbl Bakt , 7956, 167, 267-280 131 -Reczko E tJber Ansscheidung und Verweildauer des Q-Fiebers Erregers bei experimentaU infizierten Meerschweinchen Zentralbl Bakt , 7950, 156, 81-84 U2-SehaelE - , TT , ^ Zum vorkommen von C bumetu in Nahrungsmittels tienscher Herkunft Tropenmed und ParasitoL , 7977, 2, 284-286 115 133 - Sehròter G Seroepidemiologische Untersuchungen Zur Verbreitung von Rickettsiosen in Togo Tropenmed und parasitol, 7975, 26, 323-328 \34-VekiH Lichtmikroskopischer Nachweis peroxydase - Markierter Antikòrper bei passivem Arthus - Phànomen Arch Derm Forch., 7973, 247, 11-22 \35-WinkleS Die Mikroagglutination - C.bumetii Mikrobiol serol Diagnostik, Jena, 7979 \36-WeyerF Neuere Ergebnisse und aktueUe Fragestellung der Rickettsienforschung Tropenmed und parasitol 7970, 21, 313-320 116 IT/ ^ ABAKnH, A.A May^eHMe aHTMreHHo'" CTpyKTypu pMKKeTCMì^ EepHeTa (^aSU i M i [ XMMMM MeTOAOM EJieKpHOHHOMMKpoCKOnMHeCKOri MMMyHOUMTO- l y p MwKpodMoji QmAemoji H MMMyHoóHoji., 1970 I , 133-^57 Al^iOCEHKOCA, H.M PeaKqiw KojibqenpeqHnHTauMH e pacTEopuMUM aHTwreHHOM C B u r o e t i i B fluarHocTMKe Ky-pMKKeTCMosa l y p MHKPOÓHOJI 3nMfleMMoji H MMMyHoóMoji., T:976, I O , " ^ T - iìAJlAEim, H.M _ ^'jiyopecuMpramue aHTKreji aJi3 oóHapyweHHH pMKKeTcnF; l y p MMKpoÓMoji snwfleMMoji M MMMyHodMoji., 1965, , i - T 140 ''^AJIAEnA, H.M MsMeHMMBOCTb pMKKeTCHV! l y p ì'InKpodMoji snMAeMMOJi M MMMyHotìwoji., 1976, , - BAPEAH, n C KoHCTpyKpoEaHMe CTaówjibHHx HMMyHorjioóyjiMHOBux spurpouMTapHHx AHarHOCTMKyMOB ^ y p MMKpMOJi GnMAeMHoJi M MMMyHwo;ii., , , - BACiHHA, 3.A JlHxopaAKa Ky B MOPAOBCKOVÌ AGGP Kyp MnKpoÓMOJi CnHfleMHoJi, M MMMyHOÓnoJi., 1979, 5, - T43 ByCJIA, n T AnHeBMoHMMecKMe "opMu Ky-jiHxopaflKM , l'.eri per'^^ep Kyp., 1573, , 3 T44 nHHOrPAJlGB, B R fiyp MnKpodMoJi onwAeMHOJi M MMMyHoóMOJi., 1978, , - BA^.CMAH, M R MccjieflOBaHMe peaKqMH HenpnMo^ ^e^48^^JIK)THHa^MM Ha ypoBHe yjibTpacTpyKTyp ^ ^^ ^ l y p MwKpMOJi onwAeMMoji M MWMyHHOJi., " , , -,.6-i40 U7 146 rPABOBCKWil, H.M • HsyqeHMe CTaOMjiMaHpoBaHHiix GPKTPOUMTOB E peaKuHM npgMoti reMMarrjiioTMHauMM e EupycaMn rpunna MeTOflOM MHorod;aKTopHoro njiaHvipoBaHMg oKcnepwMeHTa 147 ryjIEBCKAB, C.A HoEHe jiaHHne o nojiMMoptT-HSMe pviKKeTCM!? npoBancKa M óepHera npH KyjibTMBupoEaHMM B Kyxype KjieTOK l y p MwKpoóMoJi onwpeMMoji M nMMyHoóMoJi., "^975, , - 148 ryjIEF.CKAl, C.A CjieKTpoHHOMMKpocKonwMecKoe Msy^eHvie pMKKeTCwyi óepHera C^asa I H I I B paajiHMHHx Kyjibtypax Eyp MMKppÓMOJi oniifleMHoJi M MMMyHot5Ho;i., T968, 9, 54-37 149 ryjIEBCKA^i, C.A OceHHocTM cTMKpocKonvi'iecKoro cxpoCHwa I M l ì ^ C B u r o e t i Eyp MMKpoóMOJi 3nH;!j,eKM0Ji M MMMyHoówoji., 1977, 12, T33-"38 150 :HMPPMK E.H TeneHne Ry-^HxopaaKM Men p e ^ e p E y p , 1973, l i , 1752 151 JEHEPJI PaapadoTKa MeTone norjHenm EHcoKoaKTMBHoro pecnMpaTopHo cMHUMTManbHoro BMpycHoro TtwarHocTMKyMa ^IJIH HenpaMoM peaKuMvi reMMarrjiioTHHauMM Bonpocu BwpycoJi., 1976, , - 152 - 3AP0A0BCKMÌ., H.^:- M rOJIliHEBW4, E.M i'MBHMe pHKKeXCMflX M pMKKeTCMOSOX M., HBAHOBA, J^.n nojiyneHMe aKTwreHOB D s i b i r u c u s M A peaKuHv! cB^sHEBHMa KoMruieMeHxa H HenpHMow ^ ^ ^^^ l y p MMKPOÓHOJI onM^eMMOJi M uMKyHoÓMOJi., 1968, , - T54 KAHBAn, M.P CpaBHMxejibHaH oueHKa jiEyx MCTO^IOB npwroTOBjieHMH aHTwreHa aJia 3,MarH0CTMKM JlHXOpaflKM 118iffyp MMKpodMo onM.eMHo M « K y H o o 1967 , 139-142 5 KAHBAll, ]A,V JlMHaMMKa HBKOMjieHMH KOMnircMPum ^^„ KOMnjieMeHT CBHSHBaiomMX aHTWTejI e aHTK- renaMM H pHKKeTCMii BeBMe-rn T „ -T T Asepóa^™ ^ ' ' " ^ " ^^ ^'^^^^' BH^e^ieHHBx B i y p MMKPMOJI onMAeMHoji H MMMyHnoJi., 1968, T £ i : e KAHbAl'i, H r K aOTKreKHoP xapaKTepMCTMKe p^.KKeTCwK EepHeia e y^eioM MX (f^aOBoP WSKeHMMEOCTK l y p * ^^MKpMoji onHj^eMMoji M MMMyHMoji., 1968, , - 157 KISHIMOTO, R.A Kj."jiMxopajiKa, iiMarHocTWKa TcpanMa M wMMyHonpot^MjiaKTMKa Me^ pef-ep }Kyp., 1980, 2:, 498 158 KOKOPMK 15.H ^^HyrpMKjieTOMHoe paaaOTwe pMKKeTCM^i %p, i'iMKpoÓHOJI onM^eMMOJI M MMMy HOÓMOJI., "^977, , 26-29 KyBKJIMHA, P i ^ BMpyjieHTHOCTM pasjiMHHbix oaa C o x i e l l a B u r n e t i i jìtyp MwKpMOJi 3nKjieMH0Ji M MMMVHWOJI., S CepojiorMHecKoe visyneme pacnpocTpaHeHMH Ky^jiwxopa^KM y jiio^^eJ^ i^le^ pefep jKyp., T973, 4, 7IT 173 CMEOPOB, P.E, BJIMHHMM CneUM(^MMeCKMx aHTWejI Ha fMsOBOe COCTOHHWe pMKKeTCMR BepKeTa l y p MMKpoóMoji onvijieMMoji H MMMyHoówoji., T973, IT, I l - : 174 TEPEHaEB, n $ SHaneHMe BHyTpMKo?KHor^ ajuiepraMecKovi npH e pacTBopwMHM aHTWreHOM M3 pMKKeTCMtì DepHexa npw onwjieMMojiorMMecKoM MsyMeHMw oMaroB jiMxopa;i.KM Ky iliyp MMKpMoJi onK^eMMoji M MMMynMoJi., 1973, 2, 70-74 175 TOKACE:im, H.K CoMexanHoe npMMeweHv.e cepojiorMQecKwx M M3yHeHMH Ky-pMKKeTCM03a Me^ pefep wyp., 1980, 4, I I 5 TCCTOB C uejibio ^MarHocTWK] 176 TOKACEBHM, H.K., UIPAMEK, C M FA^P, P A McnHTaHue opwTpouMTapHoro aHTureHHoro ^MarHocTMKa ^JIH BiiHEneHM: aHTMTeji K KiDKcnejuiaM BepHCTa l y p MnKpMoji 3nH;D.eMMoji M viMMyHMoji., 1985, 4, 51-55 177 ^'EJIOPOPA, H.Ki SHaneHMe ;IJIH ^warHOCTWKM :;iMxopa;iKM Q peaKUMVi cBqsuEaHMq KoMnjieMeHTa e aHTMreHoM M3 G B u m e t i i fas T Eyp MMKPOC5MO;I onM^eMMOJi M MMMyHoóMoji., T967, 9, 44-49 121 178 fOH^IKOBA T A , HHKOJIbCKM?., B B , RyxAPqYK, JI.H M BAPEAH,n.C CepojiorwMecKMe ;aaHHHe no npvipoAHUM ojiaraM onw^eMMMecKMx pwKKeTCMosoB Ha iMajie l y p , MwKpMOJi, 3nM;aeMM0Ji M HMMyHwoji., , , TT0-TT4 179 4ACO:ÌHMOBA, r.c PeaKUMH CBH3UBaHMH KoMHJieMeHTa e pMKKeXCMSHUM aHTMreHaMM B paajiMMHtix BospacTHUx r p y n n a x nacejieHMJi K y p , MMKpoÓMoji onM^eMuoji M wMMyHoóMOJi., T , , - 180 3MJIHHA, M.A B03M07KHOCTM MCnOJIbSOBaHVlH iJ^aSBot^ M3MeHMMB0CTM pMKKeTCMW B e p n e T a B cepojiorwHecKot^ ;i.MarHocTMKe jiMxopaj^KM Ky Kyp MwKpMOJi onw^eMMoji M MMMynMOJi., 9 , , - 3MJIMHA, M.A PeaKUMH yrHCTeHMn cBH3tiBaHMH KoMnjieMenra MSTO^ jiaóopaTopHoti ;^Ma^HOOTMKM Jiwxopa^^Ka Ky % p MuKpMOJi, Qnw^eMMoji M MMMyHMoji., , , - T GMCBEPr, B M B03MAH, ^ JlaòopaTopHaH ^MarHocTMKa BPipycHUx M pMKKeTCMosHUx sojiesaHMtì M T974 - 7 T8? ICTPEBOB, B.K OnHT npMMeHem^H peaKUMw nenpHMoR reMMarrjiioTMHauMM JIJIH M3yHeHVi5 KOHxaKTOB e Bosóy^MTejieM KjiemeBoro pMKKeTCMosa cKBepnoti A3MM Kyp MMKpoóMoji QnM^eMMoji M MMMyHoóMoji., , T I , I - T ... HOC TONO HOF HÀ NÓI *=!:* Lai Minh Hién ^? mm V^ l'i /Q^ NGHIÉN CLfU LfNG DUNG CÀC PHUONG PHÀP HUYÉT THANH HOC DÙNG TRONG CHAN DỒN BÉNH SĨT Q DO Coxiella burnetii CHUYEN NGÀMH : V! 5INH WOC MA s6... hop bénh tircfng tu ò Brisben (trong so càc còng nhàn xi nghiép bào quàn thit), vi vày tàc già goi bénh sot "Q" ( "Q" tijr tiéhg Anh "Querf nghTa chua xàc dinh) (29) CQng nàm 1937 Derrick dà phàn... giàu khàng nguyén thucmg co 500 D.AM Vi c làm giàu Coxiella h rat quan beri lé mite de) giàu khàng nguyèn sé quyé't dinh vi c pha lồng nòng de) Coxiella dùng de gay nhiém cho phòi gà Co thè dành