检测LAM抗体和ADA鉴别诊断结核性脑膜炎

目的：了解检测脑脊液（CSF）中抗阿拉伯糖甘露糖脂IgG抗体（LAM-IgG)和腺苷脱氨酶（ADA）指标在鉴别诊断结核性脑膜炎（结脑）方面的应用价值。方法：CSF标本143份,用斑点酶联免疫试验（dot-ELISA)检测LAM-IgG,用终点反应法检测ADA。结果：结脑患者的CSF标本103份,LAM-IgG阳性率为50.5%(53/103),ADA阳性率为60.2%(62/103),LAM-It ADA两者联检的阳性率为64.1%(66/103)。40份非结核性中枢神经系统疾病患者的CSRF标本,未检测出LAM-IgG阳性结果,检测出ADA阳性结果15例（37.5%)。结论：LAM-IgG和ADA指标鉴别诊断结脑的敏感性明显高于常规方法,两者联检可进一步提高检测敏感性,但是ADA指标的特异性较低。

DETECTION OF LAM-IG AND ADA IN CEREBROSPINAL FLUID FOR DIFFERENTIAL DIAGNOSIS OF TUBERCULOUS MENINGITIS

Objective:The aim of the study is to explore the using value of LAM IgG and ADA in CSF when them were detected for differential diagnosis of tuberculous meningitis.Methods:LAM IgG was detected by dot ELISA and ADA was detected by terminal reaction of enzymology in CSF.Results:The positive rate of LAM IgG was 50.5%(52/103),and the positive rate of ADA was 60.2%(62/103),and the positive rate of the parallel combined detection of LAM IgG and ADA was64.1%(66/103)in 103 patients with tuberculous meningitis.In the control group that consist of 40 patients with non tuberculous central nervous system diseases,the positive rate of LAM IgG Was 0 and ADA was 37.5%(15/40).Conclusion:Because the sensitivity of LAM IgG and ADA are much higher than routine method,they are good indexes of differential diagnosis of tuberculous meningitis and combined detection of them can improve the sensitivity.But the specificity of ADA is lower.