摘要
本研究旨在评价脂阿拉伯甘露糖(LAM)联合38kD蛋白的混合抗原在结核病血清学诊断中的应用价值。选取128例活动性结核病患者(活动性肺结核107例,肺外结核21例)、51例潜伏性结核感染者和68例健康对照者的血清,检测抗LAM和38kD混合抗原的IgG抗体(LAM-38kD-IgG)。结果显示,LAM-38kD-IgG检测的总敏感度为46.88%,特异度为98.53%,阳性预测值为98.36%,阴性预测值为49.63%。其中肺结核组敏感度为46.73%,肺外结核组敏感度为47.62%(P>0.05);初治组为45.54%,复治组为51.85%(P>0.05)。涂片阳性肺结核组敏感度为52.54%,高于涂片阴性组(39.58%),但差异无统计学意义(P>0.05)。LAM-38kD-IgG检测在对照组中的特异度为98.53%。其特异度远高于结核菌素试验(TST)的41.46%(P<0.01)。LAM-38kD-IgG水平与结核病病情有一定的相关性。结果提示,应用LAM和38kD混合抗原的酶联免疫吸附试验(ELISA)在诊断活动性结核病方面具有中等敏感度、极高特异度及阳性预测值,不仅可与结核病的其他诊断方法联用以提高诊断的准确性,而且特别适用于细菌学检查阴性结核病和肺外结核病的诊断。
The current study aims to evaluate the serum lipoarabinomannan-38kD-IgG （LAM-38kD-IgG） test in the serological diagnosis of tuberculosis.A total of 128 cases with active tuberculosis （107 pulmonary tuberculosis,21 extrapulmonary tuberculosis）,51 cases with latent tuberculosis infection,and 68 healthy volunteers were enrolled and diagnosed by clinic,bacteriological,and x-ray examination.All specimens were tested for the presence of LAM-38kD-IgG by using enzyme-linked immunosorbent assay （ELISA）.The results showed that the total sensitivity and specificity of the LAM-38kD-IgG test in patients with active tuberculosis were 46.88% and 98.53%,respectively.The positive predictive value and the negative predictive value of the LAM-38kD-IgG test were 98.36% and 49.63%,respectively.The sensitivities of the LAM-38kD-IgG test in the diagnosis of pulmonary tuberculosis and extrapulmonary tuberculosis were 46.73% and 47.62% （P0.05）,respectively.The sensitivity of the test in patients with smear-positive and smear-negative pulmonary tuberculosis was 52.54% and 39.58% （P0.05）,respectively.The specificity of the LAM-38kD-IgG test was higher than that of tuberculin skin test （TST） （41.46%）.It was concluded that the LAM-38kD-IgG test demonstrated an acceptable sensitivity and good specificity and positive predictive value.It is suggested that it could be used in combination with other methods to increase diagnostic accuracy,especially for culture-negative and extrapulmonary tuberculosis cases,which are difficult to diagnose.
出处
《微生物与感染》
2010年第2期68-72,共5页
Journal of Microbes and Infections
基金
"十一五"国家科技重大专项(2008ZX10003-011
2008ZX10003-003)
关键词
结核分枝杆菌
结核病
抗体
诊断
Mycobacterium tuberculosis
Tuberculosis
Antibody
Diagnosis
