摘要
目的探讨重组结核分枝杆菌黏附素（heparin-bindinghemagglutininadhesin，HBHA）、MPT64、38kD蛋白在结核性胸膜炎中的诊断价值。方法选取结核性胸腔积液患者54例、恶性胸腔积液患者40为研究对象，以HBHA、MPT64、38kD蛋白为抗原，通过酶联免疫吸附测定法（ELISA）检测患者胸腔积液中IgG抗体滴度。结果结核性胸腔积液组3种抗原对应的IgG抗体吸光度均数分别为0．630，0．430，0．470，恶性胸腔积液组3种抗原对应抗体吸光度均数分别为0．340，0．248，0．271，结核组高于恶性胸腔积液组，差异有统计学意义（P〈0．001）；ROC曲线分析结果显示，胸水中HBHA抗体的诊断临界值定为0．46时用于鉴别诊断结核性胸膜炎和癌性胸水的敏感度为90．7％、特异度为90．0％、准确度为90．4％。诊断准确度高于MPT64及38kD蛋白。结论HBHA蛋白抗体对于结核性胸膜炎与癌性胸水的鉴别诊断具有重要价值，优于MPT64及38kD蛋白。
Objective To investigate the value of recombinant HBHA, MPT64 and 38kD protein as antigens in the diagnosis of tuberculous pleurisy. Methods 54 cases with tuberculosis pleural effusion and 40 cases with malignant pleural effusion were enrolled. The level of antibody IgG in all of the specimens were analyzed by enzyme-linked immunosorbent assay （ELISA） using recombinant HBHA, MPT64 and 38kD protein as antigen. Results The means of antibody IgG of the three antigens in tuberculosis pleural effusion were 0.630, 0.430, 0.470, and the means in malignant pleural effusion were 0.340, 0.248, 0.271 respectively, IgG antibody in tuberculosis pleural effusion were higher than that of malignant pleural effusion,the difference was significant （P〈0.001）,the HBHA diagnostic sensitivity, specificity and efficiency oflgG OD level with a cut-off value of 0.46 estimated from receiver operating characteristic （ROC） analysis was 90.7%, 90.0% and 90.4% in the differential diagnosis of tuberculous pleurisy and malignant pleural effusion respectively, the efficiency is higher than that of MPT 64 and 38kD protein. Conclusion The IgG antibody of the HBHA protein can be used for the differential diagnosis of tuberculous pleurisy and malignant pleural effusion, its diagnosis efficiency is superior to that of MPT 64 or 38kD protein.
出处
《结核病与胸部肿瘤》
2014年第1期17-19,共3页
Tuberculosis and Thoracic Tumor
