Abstract: Objective To evaluate the effect of an automatic identification system of Schistosoma japonicum miracidia， and compare it with the traditional eye detection method in the simulation field. Methods A total of 260 fecal samples were collected from schistosomiasis non?endemic areas， and the test sample bottles containing schistosome miracidia were prepared according to different experimental needs. Thirty fecal samples for the sensitivity test were separately added with five fresh miracidia per sample， and then the mixed samples were detected by two experienced technicians （with more than 15 years’ traditional test experience） or the automatic system. The positive detection rates were compared between the two methods. Thirty fecal samples for repetition test were separately added with ten fresh miracidia per sample， and then the mixed samples were detected separately with the automatic identification system by two experienced technicians. The results were compared between two persons. The two methods including the automatic identification system and the traditional eye detection method were carried out blindly with totally 200 samples in the simulation field. There were three groups （each with 30 samples）： Group 1 with more than 21 fresh miracidia， Group 2 with 6 to 20 fresh miracidia， and Group 3 with 1 to 5 fresh miracidia. The other 110 samples were as a negative group. The detection time， accuracy， missed detection rate， and false detection rate of the two methods were statistically compared. Results The positive detection rates of the 30 positive samples were 43.33% and 33.33% by the two technicians with the traditional eye detection method， respectively， while the detection rate was 80.00% by the automatic identification system， and the difference was statistically significant （[χ2] = 7.05， [χ2] = 12.97， both P < 0.01）. Thirty positive samples were detected by the two technicians using the same automatic identification system， and the positive detection rates of the two were 96.67% and 86.67%， respectively， with no significant difference （[χ2] = 0.27， P > 0.05）. The experiments showed that the correct detection rate of the positive samples was 98.00% by the automatic identification system， which was higher than 79.75% by the traditional eye detection method. The detection time of the automatic identification system was shortened by half compared with that of the traditional eye detection method. The missed detection rate， and false detection rate of the automatic identification system were 2.22% and 1.82%， respectively， which were much lower than 35.56% and 7.73% of the traditional eye detection method. Conclusions Compared with the traditional eye detection method， the automatic identification system of S. japonicum miracidia has the advantages of high sensitivity， good repeatability， short detection time， high accuracy， low missed detection rate， and low false detection rate. It can be used in the field and clinical detection in replacement of the traditional eye detection method.

Key words: Schistosoma japonicum； Miracidium； Simulation experiment； Automatic identification system； Etiological diagnosis

摘要： 目的 通过模拟现场实验，比较血吸虫毛蚴动态自动识别系统与传统人工肉眼观察法检测血吸虫毛蚴的效果，以评价毛蚴自动识别系统替代人工肉眼观察法检测血吸虫毛蚴的应用价值。方法 采集血吸虫病非流行区居民粪便样本260份，按不同实验需要制作含有血吸虫毛蚴的检测样本瓶。制作30份阳性样品（每瓶中放入5条毛蚴）用于敏感性实验，由2名检验人员采用传统人工肉眼观察法检测，再采用毛蚴自动识别系统进行检测，比较阳性检出率。制作30份阳性检测样品（每瓶中放入10条毛蚴），由2名操作人员分别采用同一台毛蚴自动识别系统在不同时间检测，比较检测结果。从200份阴性粪便样品中随机抽取90份，加入不同数量毛蚴，制作成阳性样品。将90份阳性样品分为3组，每组30份。第1组每份样品分别加入21条毛蚴、第2组每份样品分别加入6 ~ 20条毛蚴、第3组每份样品分别加入1 ~ 5条毛蚴，然后与其他110份阴性样本混合。采用盲法的原则，由2名检验人员先采用传统人工肉眼观察法检测该200份样品，再用毛蚴自动识别系统进行检测，比较两者检测时间、正确率、漏检率、误检率等参数。结果 2名检测人员采用人工肉眼观察法对30份阳性样本的检出率分别为43.33%和33.33%，而毛蚴自动识别系统检出率为80.00%，差异均有统计学意义（[χ2 =7.05]、12.97，[P均< 0.01]）。2名检测人员采用同一台毛蚴自动识别系统检测30份阳性样本的检出率分别为96.67%和86.67%，差异无统计学意义（[χ2] = 0.27，P > 0.05）。毛蚴自动识别系统检测血吸虫毛蚴阳性样品的正确率为98.00%，高于人工肉眼观察法的79.75%；检出阳性样本的用时仅为人工肉眼法的50%；毛蚴自动识别系统的阳性漏检率和误检率分别为2.22%和1.82%，明显低于人工检测的35.56%和7.73%。结论 与传统人工肉眼观察法相比，毛蚴自动识别系统检测血吸虫毛蚴具有敏感性高、重复性好、检测时间短、正确率高、漏检率和误检率低等优点，在现场和临床血吸虫毛蚴检测中可取代人工肉眼观察法，值得进一步推广应用。

关键词: 日本血吸虫；毛蚴；模拟实验；自动识别系统；病原学诊断