The relationship between Streptozyme test (SZ) and other antistreptococcal antibody titers was studied.
Correlation coefficients between SZ and ASO, ASK and All were 0.7999, 0.6927 and 0.7646, respectively. Discordance rates were 51.4%, 28.9% and 33.3% respectively. The majority of discordance was consisted of the cases with positive SZ and low titers of other antibodies. False negative cases of SZ were seen in only 2% exclusively with ASK. In the sera with positive SZ, 28 to 57% had high titers of single antibody; 52 to 71% had high titers of at least one of two antibodies; and 76.1% had high titers of at least one of three other antibodies; therefore, 23.9% of them were not detected by simultaneous, determinations of ASO, ASK and AH.
Given titers of ASO, ASK and All were divided by each highest normal values (166, 1280 and 128, respectively) and named “Relative Amount of Antibody (RAA) ”. RAAs of different antibodies are comparable in the same scale each other. They are added and called “Cumulative RAA (CRAA) ”. SZ had the highest correlation coefficient with CRAA of three other titers (r=0.9076) as compared with those of two titers or of each single RAA. On the other hand, the correlation coefficient between SZ and the single maximum value of three RAAs was 0.7270, which was significantly lower than that of SZ vs. CRAA of three titers (p<0.05). It was concluded that SZ reacts with the arithmetic sum of other antibodies, not with single strongest one. In the above mentioned cases with positive SZ and negative three antibodies, CRAA of three titers were significantly higher than that of negative SZ group. This additive character of antibodies in Streptozyme test is important in the clinical application of it.
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