摘要
目的探讨痰液MPB64蛋白检测在临床诊断肺结核的价值及常见菌对MPB64检测的影响。方法以11例涂片抗酸染色阳性且胸片出现肺部阴影的患者的痰标本为实验组，以11例涂片抗酸染色阴性且胸片无肺部阴影的患者的痰标本为对照组，分别进行免疫胶体金法检测MPB64蛋白、荧光定量聚合酶链式反应（PCR）检测结核杆菌DNA和涂片抗酸染色，对3种检测方法的检测结果进行比较、分析；对临床送检痰标本中分离的65株常见菌，用蛋白胨水增菌24h，采用免疫胶体金法检测MPB64。结果实验组中，免疫胶体金法检测MPB64蛋白、荧光定量PCR检测结核杆菌DNA的敏感度分别为72．72％、45．45％，免疫胶体金法显著高于荧光定量PCR法，但其特异度（45．45％）和准确度（59．09％）则低于荧光定量PCR（100．00％、72．73％）；MPB64蛋白检测与涂片染色、荧光定量PCR检测结果的符合率分别为50．00％、59．09％；25株金黄色葡萄球菌增菌液中MPB64检测试验阳性，阳性率100％，其余菌株增菌液阴性。结论痰液中MPB64蛋白检测快速、简便、敏感性高，但特异性低；金黄色葡萄球菌菌株的存在可能造成对痰液MPB64检测的假阳性。
Objective To explore the clinical value of MPB64 detection for diagnosing pulmonary tuberculosis and the influence of common pathogen bacteria on MPB64 detection. Methods 11 sputum samples separated from the patients who presented positive acid fast stain and had spots found on their lungs in chest X-ray were taken as experimental group. 11 sputum samples separated from the patients who presented negative acid fast stain and had found no spots on their lungs in chest X-ray were taken as control group. These samples were tested by Gold-immunochromatography assay, Real-time Quantitative PCR, and smear acid-fast staining respectively. Then the results tested by these 3 methods were compared and analyzed. The 65 strains of common pathogen bacterias isolated from clinical sputum samples were cultured with peptone water for 24 hours. MPB64 were tested by Gold-immunochromatography assay. Results The sensitiv- ity of Gold-immunochromatography assay for testing MPB64 （72.72%） was significantly higher than that of Real-time Quantitative PCR for testing DNA （45.45%）. However, the specifity （45.45%） and accuracy （59.09%） of Gold- immunochromatography assay were lower than that of Real-time Quantitative PCR（ specifity ： 100.00%; accuracy： 72.73% ）. The Coincidence rate of Gold-immunochromatography assay with Real-time Quantitative PCR and smear acid-fast staining were 50.00%, 59.09%, respectively. The MPB64 test was positive in cultured bacteria liquid of 25 strains Staphylococcus bacteria. The positive rate was 100%. The MPB64 test was negative in the other microbial strains. Conclusions The method of MPB64 test in samples is fast, easy, and highly sensitive but has a low specifity. The existence of staphylococcus bacteria may lead to a false positive result in MPB64 detection.
出处
《国际医药卫生导报》
2012年第15期2139-2142,共4页
International Medicine and Health Guidance News
基金
国家“十一五”重大传染病专项资助项目（2009ZX10003～018）
广州市医药卫生科技重大项目（2009-Zda-03）
关键词
肺结核
MPB64
常见菌
假阳性
Pulmonary tuberculosis
MPB64 protein
Common pathogen bacteria
False positive
