脂阿拉伯甘露聚糖诊断结核性脑膜炎的评价

目的　评价分枝杆菌脂阿拉伯甘露聚糖(LAM)的诊断价值并给出受试者工作特征曲线(ROC)。方法 应用斑点金免疫渗滤技术平行检测结核性脑膜炎(TBM)及非结核性神经精神系统疾病血清(Serum)和脑脊液(CSF)中抗LAM抗体。Serum稀释25倍,CSF分别按1、2、4、8、16、32倍稀释。进行抗LAM抗体检测。结果 Serum敏感性(Sencitivity,Se)为96.9%,特异性(Specificity,Sp)58.3%。CSF在稀释倍数为12、4、、8、163、2时Se分别为93.6%,90.6%,56.3%,37.5%,12.5%,3.1%,Sp分别为83.3%、95.8%、95.8%、100%、100%、100%。最佳截切值(Cut-Off)为2倍稀释。统计分析表明,CSF在2倍稀释时其Se与Serum无显著性差异,但Sp有显著性差异。结论 应用斑点金免疫渗滤技术检测抗LAM抗体诊断价值较高。

The clinical evaluation of lipoarabinomannan for diagnosisof tuberculous meningitis

Objective To evaluate the clinical value of lipoarabinomannan for diagnosis of tuberculous meningitis and to determine the ROC.Method The detection of anti-LAM-antibodies made by dot-immunolgold filtration assay in sera and cerebrospinal fuid(CSF) from patients with tuberculous meningitis and non-tuberculosis.The sera was diluted by 25 times and the CSF by 1,2,4,8,16,32 times.Results The sensitivity and specificity in serum was 96.9% and 58.3% respectively.The two indexes in CSF with the dilution of 1,2,4,8,16,32 times were 93.8%,90.6%,56.3%,37.5%,12.5%,3.1% and 83.3%,95.8%,95.8%, 100%,100%,100%.The best cut-off value was in CSF with dilution 2 times on which the specificity was significant difference compared with that of sera,but there was no significant different on sensitivity.Conclusion The detection of anti-LAM-antibodies in CSF made by dot-immunolgold assay is a useful tool.