摘要
目的分析结核分枝杆菌免疫球蛋白G(IgG)、免疫球蛋白M(IgM)抗体及结核分支杆菌糖脂免疫球蛋白G(LAM-IgG)联合检测对活动性肺结核的诊断价值。方法选取2019年3月至2020年7月新乡医学院附属第一医院收治的106例活动性肺结核患者作为观察组(根据患者病情变化分期分为三个亚组:进展期28例、好转期41例、稳定期37例),选取101例同期住院治疗非活动性肺结核患者作为对照组,99例健康体检人群为健康组。比较各组结核分枝杆菌IgG、IgM抗体及LAM-IgG表达情况,并计算结核分枝杆菌IgG、IgM抗体、LAM-IgG单独以及联合检测对活动性肺结核的诊断敏感度、特异度、阳性预测值、阴性预测值。结果结核分枝杆菌IgG、IgM抗体及LAM-IgG阳性表达情况:观察组>对照组>健康组,差异有统计学意义(P<0.05)。肺结核患者结核分枝杆菌不同时期IgG、IgM抗体、LAM-IgG阳性表达情况:进展期>好转期>稳定期,病灶≥3肺野患者结核分枝杆菌IgG、IgM抗体、LAM-IgG阳性表达率明显高于病灶<3肺野患者,差异均有统计学意义(P<0.05)。以痰培养检查作为金标准,106例患者痰培养阳性率为37.74(40/106)。IgG+IgM+LAM-IgG联合检测对活动性肺结核诊断敏感度、特异度、阳性预测值、阴性预测值分别为92.50%、98.46%、94.87%、95.52%,联合诊断活动性肺结核效能明显高于三者单独检测(P<0.05)。结论结核分枝杆菌IgG、IgM抗体及LAM-IgG联合检测可提高对活动性肺结核诊断效能,其阳性表达率与患者病情严重程度密切相关。
Objective To analyze the value of combined detection of Mycobacterium tuberculosis IgG,IgM antibody and LAM-IgG in the diagnosis of active pulmonary tuberculosis.Methods 106 patients with active pulmonary tuberculosis admitted to this hospital from March 2019 to July 2020 were selected as the observation group(according to the patient’s disease changes,they were divided into three subgroups:28 cases in advanced stage,41 cases in improvement stage,and 37 cases in stable stage).In the same period,101 patients with inactive tuberculosis were selected as the control group,and 99 patients who had healthy physical examination were selected as the healthy group.The levels of Mycobacterium tuberculosis IgG,IgM antibody and LAM-IgG in the different groups were compared.The sensitivity,specificity,positive predictive value,and negative predictive value of single detection and combined detection of Mycobacterium tuberculosis IgG,IgM antibody,and LAM-IgG in the diagnosis of active pulmonary tuberculosis were calculated.Results The titers of anti-Mycobacterium tuberculosis IgG,IgM antibody and LAM-IgG in the observation group were significantly higher than those in the control group and the healthy group,and the titers in the healthy group were the lowest(P<0.05).The titers of Mycobacterium tuberculosis IgG,IgM antibody,and LAM-IgG in patients with pulmonary tuberculosis in the advanced stage were significantly higher than those in the improvement tage and the stable stage.The titers in the stable stage were the lowest(P<0.05).The titers of Mycobacterium tuberculosis IgG,IgM antibody,and LAM-IgG in patients with lesions≥3 lung fields were significantly higher than those in patients with lesions less than 3 lung fields(P<0.05).Sputum culture examination was used as the gold standard.The positive rate of sputum cultures in 106 patients was 37.74%(40/106).The sensitivity,specificity,positive predictive value,and negative predictive value of the combined detection of IgG+IgM+LAM-IgG in the diagnosis of active tuberculosis were 92.50%,98.46%,94.87%,and 95.52%,respectively.The efficacy of combined examination in the diagnosis of active pulmonary tuberculosis was significantly higher than that of the three were detected independently(P<0.05).Conclusion The combined detection of Mycobacterium tuberculosis IgG,IgM antibody and LAM-IgG can improve the diagnostic efficacy of active pulmonary tuberculosis,and its positive expression rate is closely related to the severity of the patient’s illness.
作者
韩伟
崔俊伟
黄健
潘艳静
董伟
高盼盼
HAN Wei;CUI Junwei;HUANG Jian;PAN Yanjing;DONG Wei;GAO Panpan(Department of Tuberculosis,the First Affiliated Hospital of Xinxiang Medical College,Xinxiang,Henan,China,453100)
出处
《分子诊断与治疗杂志》
2022年第1期10-13,18,共5页
Journal of Molecular Diagnostics and Therapy
基金
河南省医学科技攻关计划联合共建项目(2018020344)。
