快速酶联免疫吸附法检测血清脂阿拉伯甘露糖—IgG对肺结核的…

目的评估脂阿拉伯甘露糖－ＩｇＧ（ＬＡＭ－ＩｇＧ）检测对活动性肺结核的诊断价值，方法采用快速酶联免疫吸附法（ＥＬＩＳＡ）检测９０例肺结核，５３例肺癌患者及３０例正常人血清中的ＬＡＭ－ＩｇＧ。结果，肺结核组ＬＡＭ－ＩｇＧ阳性率为８２％，其中痰结核杆菌除（＋）培（＋）组达９６％，涂（－）培养（－）组为６９％，肺癌组４例阳性，正常组１例阳性，假阳性率分别为８％和３％，结论，提示血清ＬＡＭ－ＩｇＧ测量是肺结     

检测血清抗脂阿拉伯甘露糖IgG抗体（LAM—IgG）对结核病的诊断价值

目的 评价ＲａｐｉｄｆｌＴＭ试剂盒检测血清抗脂阿拉甘露酯ＩｇＧ抗体对结核病的诊断价值。方法 采用快速斑点免疫金渗滤法检测活动性肺结核６０例，骨结核６例，胸膜炎３例，脑膜炎２例，肺癌３０例及３０例健康人血清中ＬＡＭ－ＩｇＧ。结果 活动性结核病组ＬＡＭ－ＩｇＧ阳性率６９％，肺癌及正常对照组ＬＡＭ－ＩｇＧ假阳性率５％，结论血清ＬＡＭ－ＩｇＧ测定对活动性结核病有较好的辅助诊断价值。     

检测血清中BCG－A_（60）抗体对结核病诊断的临床意义

ＢＣＧ－Ａ＿（６０）是从牛型结核分支杆菌的胞浆中提纯出来的抗原，为了解用聚合酶联免疫（ＥＬＩＳＡ）法检测血清中抗ＢＣＧ－Ａ＿（６０）抗体对结核病诊断的临床意义，对７３４例健康人和非结核病人，以及５６０例结核病患者作了抗ＢＣＧ－Ａ＿（６０）抗体的检测。结果证实，ＥＬＩＳＡ－Ａ＿（６０）·ＩｇＧ诊断结核病的特异性为８９．３％，敏感性为８４．５％，获得较满意的效果，认为可用于临床对结核病的辅助诊断。还发现在活动性原发型肺结核中ＩｇＭ的阳性率明显高于ＩｇＧ。ＩｇＭ除在急性期病例阳性率高外，而且也见于慢性结核病例。这些证明ＩｇＭ的血清学分析在结核病早期诊断中也是一项重要的辅助手段，在诊断结核性脑膜炎，以及肺结核合并其它活动性肺外结核中有补充ＩｇＧ的价值。     

ELISA法检测痰中抗PPD—IgG对肺结核的诊断价值

为探讨对活动性肺结核方便，有效的诊断方法，应用ＥＬＩＳＡ法检测８６例活动性肺结核，２６例肺癌，３６例细菌性肺炎患者痰中抗ＰＰＤ－ＩｇＧ。结果显示，活动性肺结核痰中抗ＰＰＤ－ＩｇＧ与非结核组比较有极显著性差异。该法诊断活动性肺结核的敏感性为８１．４％，特异性为１００％，阳性预测值为１００％，阴性预测值为６９．２％。认为是比较理想的新的免疫学诊断方法。     

快速ELISA法检测血清LAM—IgG对肺结核诊断价值的观察

本文采用快速ＥＬＩＳＡ法检测了肺结核、肺癌和健康人血清中ＬＡＭ－ＩｇＧ，以观察其在结核病诊断的吉核组阳性率８２．２％，涂培组阳率９６．４％，涂培组则为６８．６％，而肺癌组及健康组假阳性率各为７．５％、３．４％。结果提示血清中ＬＡＭ－ＩｇＧ检测对活动性肺结核有辅助诊断意义。     

糖脂抗原和包膜抗原血清学检测活动性结核IgG抗体价值评估

评估脂阿拉伯甘露糖－ＩｇＧ和包膜蛋白－ＩｇＧ对活动性结核的诊断价值。方法两种抗原分别采用快速和常规酶联免疫吸附法进行检测。选择１０８活动性结核，６９例非结核肺肺部疾患血清平持检测结核分支杆菌ＩｇＧ抗体。     

血清抗脂阿拉伯甘露聚糖及38kDa抗体的检测对涂阴肺结核及肺外结核诊断价

目的 评估血清抗脂阿拉伯甘露聚糖３８ｋＤａ抗体（ＬＡＭ－３８ｋＤａ－ＩｇＧ）检测对涂阴肺结核和肺外结核的诊断价值。方法 采用斑点免疫金渗滤法检测５７例涂阴肺结核，５２例肺外结核，３２例涂阳肺结核，２９例肺癌患者及３３例正常人血清中的ＬＡＭ－３８ｋＤａ－ＩｇＧ。结果 涂阴肺结核组ＬＡＭ－３８ｋＤａ－ＩｇＧ阳性率为７３．７％，其中痰结核杆菌涂（－）培（＋）组为８４．６％，涂（－）培（－）组为７０．５％；肺外结核组阳性率为７１．２％；涂（＋）肺结核组阳性率９３．８％；肺癌组假阳性率３１％；健康组假阳性率９．１％。结论 提示血清ＬＡＭ－３８ｋＤａ－ＩｇＧ测定对涂阴肺结核和肺外结核有一定的辅助诊断价值。     

人巨细胞病毒感染与脑血栓形成关系的研究

采用高敏感性ＥＬＳＡ法和ＰＣＲ技术分别检测５８例脑血栓病人的血清特异性ＨＣＭＶ－ＩｇＡ、ＩｇＭ及悄ＨＣＭＶ－ＤＮＡ。结果显示，脑血栓病人活动性ＨＣＭＶ感染率（ＩｇＭ／ＩｇＡ）和尿ＨＣＭＶ ＤＮＡ阳性率分别为２４．１４％和８．６２％，而对照组为２．７８％和０，两组有显著性差异（Ｐ〈０．０１）提示ＨＣＭＶ活动性感染与脑血栓形成有关。     

联合检测对菌阴肺结核诊断价值的探讨

本文探讨联合血清抗体ＰＰＤ－ＩｇＧ、ＬＡＭ－ＩｇＧ、ＴＢ－ｄｏｔ、ＩＣＴ卡及痰聚合酶链反应（ＰＣＲ）检测对菌阴肺结核的诊断价值。１对象与方法１．１选例和分组（１）实验组：菌阴肺结核７０例,３次涂片、１次培养均阴性。Ｘ线胸片有活动性肺结核征象和／或临床症状,经抗结核治疗证实为肺结核者。（２）非结核肺部疾病组共４６例。其中肺癌３２例、ＣＯＰＤ１０例、肺炎４例,均经相应检查确诊。（３）菌阳肺结核对照组４０例,其中３２例为涂（＋）培（＋）,余８例涂（－）培（＋）。１．２检测方法痰ＰＣＲ荧光法采用深圳匹基…     

日本血吸虫副肌球蛋白全基因核酸疫苗在小鼠诱生的保护性免疫力

目的： 研究日本血吸虫大陆株副肌球蛋白全基因核酸疫苗免疫Ｃ５７ ＢＬ／６ 及ＢＡＬＢ／ｃ 小鼠诱生的保护性免疫力。方法： 将构建的日本血吸虫大陆株副肌球蛋白全基因核酸疫苗 （ｐＣＭＶ－ＳｊＣ９７） 经后腿胫前肌免疫Ｃ５７ＢＬ／６及ＢＡＬＢ／ｃ小鼠, 共免疫３ 次, 每次间隔３ ｗ ｋ。末次免疫后３ ｗ ｋ 以血吸虫尾蚴攻击感染, ６ ｗｋ 后计数成虫负荷及肝、脾、肠组织虫卵数。设不含ＳｊＣ９７ 编码基因的空载体质粒免疫组为对照组。结果： ｐＣＭＶ－ＳｊＣ９７ 免疫Ｃ５７ ＢＬ／６ 小鼠主要诱生ＩｇＧ２ａ 和ＩｇＧ２ｂ 亚类, 而免疫ＢＡＬＢ／ｃ小鼠除诱生ＩｇＧ２ａ 和ＩｇＧ２ｂ 亚类外, 还诱生ＩｇＧ１。ｐＣＭＶ－ＳｊＣ９７ 免疫Ｃ５７ＢＬ／６ 小鼠诱生较明显的减虫率 （３５．５％ ～４１．１％ ） 和减卵率 （肝、脾及肠组织减卵率分别为４４．５％ ～５９．６％ 、５６．７％ ～８２．４％ 及５７．９％ ）, 而对ＢＡＬＢ／ｃ小鼠未诱生保护性。结论： ｐＣＭＶ－ＳｊＣ９７ 核酸疫苗能对Ｃ５７ＢＬ／６ 小鼠诱生较明显保护性免疫力, 而对ＢＡＬＢ／ｃ 小鼠未诱生免疫保护力     

Serological diagnosis of childhood tuberculosis by estimation of mycobacterial antigen 60-specific immunoglobulins in the serum

Setting: An ELISA assay based on mycobacterial antigen 60 (A60) for the estimation of specific immunoglobulins in the serum has been used successfully for the rapid diagnosis of tuberculosis in studies done predominantly in Western countries. In a recent Indian study, encouraging results were reported in adult tuberculosis.Objective: To evaluate the utility of this ELISA test for rapid diagnosis of different clinical forms of tuberculosis in Indian children.Design: ELISA test based on mycobacterial A60 was used to estimate specific IgM, IgA and IgG antibodies in the sera obtained from 452 cases of tuberculosis and 161 controls in the paediatric population of Delhi, India.Results: Of the 161 controls, only 7.4% were positive for IgM, 4.3% for IgG, 3.7% for IgA and 8% when a combination of IgM and IgA was considered. Of 58 cases of definite pulmonary tuberculosis, 55.2% were positive for IgM, 32.7% for IgG, 36.2% for IgA and a high positivity of 72.4% was seen when IgA and IgM estimations were combined. The corresponding figures in 150 cases of definite extrapulmonary tuberculosis were 57.3%, 36.6%, 38% and 76.6%. A relatively weak serology was observed in 244 cases of probable tuberculosis. A very high positivity (95%) was seen in acid-fast bacilli-positive cases of tuberculosis.Conclusions: Our findings point to a very good specificity (92%) and a reasonably good sensitivity (75.5%) of the test when combined IgM and IgA antibody titres are considered in the diagnosis of childhood tuberculosis.     

Comparison of sputum positive rate between bilateral and unilateral lung tuberculosis

PURPOSE: Comparing sputum smear/culture positive rate between unilateral lung tuberculosis and bilateral ones with similar extent of lesion. SUBJECT AND METHOD: Retrospective review of patients' records in the author's hospital from Jan. 1/2002 to Sep. 30/2003. RESULTS: In unilateral (N=58) and bilateral (N=82) lung tuberculosis of "Gakkai classification" (= chest X-ray classification of lung tuberculosis according to the Japanese Society for Tuberculosis). II 2 (cavitary lung tuberculosis with moderate extent), positive rates of the initial sputum investigation by smear/Ogawa culture/MGIT were, 84.6% vs. 74.0%/ 88.5% vs. 93.2%/93.5% vs. 97.1%, respectively, and no significant difference was found. Similarly, in Gakkai classification III 1 (non-cavitary lung tuberculosis with minimal extent) and in Gakkai classification III 2 (non-cavitary lung tuberculosis with moderate extent), no significant differences were found in sputum bacilli positive rates between unilateral and bilateral lung tuberculosis. CONCLUSION: Sputum smear and culture positive rates of bilateral lung tuberculosis showed no significant differences with that of unilateral one with similar extent.     

4种方法联合检测在菌阴肺结核临床诊断价值的研究

目的　探讨痰聚合酶链反应——微孔板杂交技术(PCR ELISA)、抗脂阿拉伯甘露糖(LAM-IgG)抗体、结核菌素(PPD)1TU皮试以及血清可溶性白细胞介素2受体(sIL-2R)水平,4种方法联合检测对初治菌阴肺结核患者临床诊断的意义。方法 以上述4种方法检测初治菌阳肺结核57例,初治菌阴肺结核58例,非结核肺疾病41例,健康对照36例。分别进行单项与联合检测,观察初治菌阴肺结核的特异性与敏感性。结果 PCR-ELISA、LAM-IgG、TB-PPD及sIL-2R单项检测对菌阴肺结核的阳性检出率依次分别为 43.1%,37.9%,31.0%,50.0%。联合检测对菌阴肺结核的阳性检出率2联、3联及4联依次分别为 56.9%,70.7%,84.5%,与单项检测的最高阳性检出率相比由50.0%提高到84.5%;联合检测的特异性分别为92.2%,88.3%和84.4%。结论 通过4种方法联合检测能显著提高菌阴肺结核的阳性检出率,同时也保持了相对高的特异性。联合检测对于菌阴肺结核的诊断,具有实用意义。     

TaqMan聚合酶链反应技术检测结核分支杆菌DNA及其临？…

目的 探讨ＴａｑＭａｎ聚合酶链反应（ＴａｑＭａｎ－ＰＣＲ）技术在肺结构诊断中的价值。方法 对１６８例活动性肺结核、５７例肺癌患者的痰和外周血及３４－例健康对照外周血,同时应用ＴａｑＭａｎ－ＰＣＲ、ＰＣＲ检测,并与痰涂片法、ＢＡＣＴＥＣ法及改良罗氏培养法结果进行比较。结果 ＴａｑＭａｎ－ＰＣＲ检测痰和外周血总的阳性率分别为５３．０％和６１．３％,显著高于ＰＣＲ、痰涂片法、ＢＡＴＣＴＥＣ法及改良罗氏培     

Tuberculosis antigen A60 serodiagnosis in tuberculous infection: Application in extrapulmonary and smear-negative pulmonary tuberculosis

Abstract An ELISA diagnostic test for tuberculosis antigen A60 (TBA60) IgG/IgM was used in a tertiary referral hospital in Taiwan. From June 1992 to December 1993, serum samples obtained from 907 patients were analyzed for TBA60 IgG and IgM titres. The final diagnosis of these patients was confirmed by microbiological study and clinical follow up for 18–24 months. Among 147 patients with active pulmonary tuberculosis, IgG was positive in 112 (76.2%), IgM was positive in 14 (9.52%). Among 90 patients with active extrapulmonary tuberculosis, IgG was positive in 53 (58.9%), IgM was positive in 9 (10%). Among 153 patients with inactive tuberculosis, IgG was positive in 28 (18.3%), IgM was positive in 1 (0.6%). Among 517 patients with nontuberculous disease, IgG was positive in 50 (9.7%), IgM was positive in 3 (0.6%). In this study population with 26% (237/907) active tuberculous infection rate, the TBA60 ELISA IgG had a diagnostic sensitivity of 69.6% and a specificity of 92.1%. These results indicate a positive predictive value of 67.9% and a negative predictive value of 89.2%. The sensitivity of IgM was 10.5% and specificity, 99.4%. The serum IgG titre had good correlation with the extent of pulmonary disease. Patients with smear-positive pulmonary TB had a higher percentage of IgG seropositivity (83.9%) than those with smear-negative pulmonary TB (70.6%) and extrapulmonary TB (58.9%). In 50 cases with active tuberculosis, follow- up examinations were carried out one month after treatment. In 18 cases with initially negative IgG and IgM titres, 13 showed elevation of serum IgG titres into positive level, one had positive seroconversion of IgM which was the only serological marker indicating active infection. Therefore, 77.8% (14/18) gained diagnostic benefit from follow-up serological examination. It was concluded that TBA60 IgG and IgM ELISA is a useful test when diagnosing tuberculosis. This test also assists in the clinical judgement of tuberculosis when used as an adjunct to symptoms and sputum smear, and for monitoring therapeutic response at the commencement of treatment.     

结核分枝杆菌特异性38kD多肽抗原提纯及其血清学诊断价值的研究

目的提纯结核分枝杆菌特异38kD多肽抗原,建立基于38kD多肽抗原(P38)的斑点金免疫渗滤法(DIGFA)检测结核病人血清标本,评价38kD多肽用于结核病血清学诊断抗原的实际价值。方法采用超声破碎、SDS-PAGE、切胶浸泡回收法提取结核分枝杆菌H37Rv株的38kD多肽抗原。建立以38kD多肽为包被抗原的DIGFA(P38-DIGFA),并检测147例临床确诊的活动性肺结核病人血清标本。同时建立以结核分枝杆菌脂阿拉伯甘露糖(LAM)为包被抗原的DIGFA(LAM-DIGFA)作为对照。结果结核分枝杆菌H37Rv株38kD多肽抗原提取物经SDS-PAGE后仅显示为单一的条带,并可与临床确诊的肺结核病人阳性血清标本呈阳性免疫印迹反应。P38-DIGFA和LAM-DIGFA检测肺结核病人血清标本的总阳性率分别为84.4%(124/147)和76.2%(112/147),其中59份痰涂片及培养均阳性的肺结核病人血清标本P38-DIGFA和LAM-DIGFA阳性率分别为88.1%(52/59)和84.7%(50/59),88份痰涂片及培养均阴性的肺结核病人血清标本P38-DIGFA和LAM-DIGFA阳性率分别为81.8%(72/88)和70.5%(62/88),60例气管炎病人血清标本阳性率分别为13.3%(8/60)和6.7%(4/60),120例健康人血清标本阳性率分别为5.8%(7/120)和5.0%(6/120)。各P38-DIGFA和LAM-DIGFA检测阳性率之间均无显著性差异。结论结核分枝杆菌38kD多肽作为抗原用于结核病血清学检测时,其敏感性和特异性与LAM相似,可应用于研发结核病血清学诊断试剂盒。     

TaqMan-PCR技术诊断结核病的临床应用研究

目的　探讨TaqMan-聚合酶链反应 (TaqMan-PCR)技术在结核病快速诊断中的临床价值。方法 对 155例活动性肺结核患者的痰和外周血、130例结核性胸膜炎患者的胸腔积液和外周血以及 61例结核性脑膜炎患者的脑脊液和外周血应用TaqMan -PCR检测结核分支杆菌DNA ,痰、胸腔积液和脑脊液进行抗酸染色涂片检查 ,另外 ,痰标本还进行了BACTEC和改良罗氏培养；同期以52例肺癌患者的痰和外周血、50例恶性胸腔积液患者的胸腔积液以及 33例健康人的外周血作为对照进行TaqMan-PCR检测。 结果 155例活动性肺结核患者的痰和外周血、130例结核性胸膜炎患者的胸腔积液和外周血以及 61例结核性脑膜炎患者的脑脊液和外周血TaqMan-PCR的阳性率分别为 49.0%和 51.6%、45.4%和 38.5%以及 50.8%和 42.6% ,痰、胸腔积液和脑脊液TaqMan-PCR的阳性率显著高于抗酸染色涂片以及BACTEC和罗氏培养 (P＜0.05)。TaqMan-PCR检测痰、胸腔积液和外周血的特异性分别为 96.2%、98%和 96.5%。结论 TaqMan-PCR具有较高的敏感性和特异性 ,对结核病的快速诊断具有一定的价值。     

广东省结核病疫情流行状况分析

目的　通过分析广东省结核病疫情,探讨广东省结核病控制的进一步措施。方法 利用1979年、1990年和2000年3次结核病流调资料和世行贷款结控项目资料分析广东省结核病疫情流行状况及趋势。结果 3次结核病流调患病率分别为862.87/10万、493.43/10万、351.74/10万,涂阳患病率分别为232.89/10万、111.84/10万、106.75/10万。1992年实施世界银行贷款结核病控制项目以来,结核病新登记率和涂阳新登记率逐年提高。治疗满疗程的涂阳病人治愈率逐年提高,达到85%以上。结论 广东省结核病疫情呈下降趋势。随着现代结核病控制策略的应用,采用DOTS策略,抓好流动人口的结核病发现和管理,控制耐药病例的产生,才能有效地控制结核病疫情的流行。     

荧光双标记定量结核杆菌在肺结核诊断中的应用价值

目的　对痰荧光双标记定量结核杆菌检测法用于肺结核诊断的价值进行评估。方法　 135例肺结核患者和 6 0例非肺结核患者的痰液用荧光染色涂片、改良罗氏培养和荧光双标记定量结核杆菌法检测 ,同时测定血结核抗体。结果　菌阳、菌阴肺结核组荧光双标记法的敏感性分别为 83% ,5 3% ,特异性为 10 0 % ;血结核抗体的敏感性分别为 6 3% ,5 3% ,特异性为 95 %。结论　荧光双标记法诊断肺结核的特异性高 ,适合于临床应用 ,而敏感性有待进一步提高。     

深圳市某看守所结核病调查结果分析

目的了解羁押人群结核病发病情况,为今后羁押人群结核病防治工作的开展提供理论依据。方法对深圳市某看守所4 228名羁押人员进行胸部X线缩影片筛查,可疑肺部阴影者全部行X线胸片复查和痰涂片3次检查。结果X线胸片异常阴影92例,其中稳定性病灶34例（37.0%）,活动性病灶50例（54.3%）（6例新发涂阳肺结核）,8例感染病灶。44例涂阴肺结核病人中,入看守所前有结核病史11例（25%）;6例新发涂阳肺结核均有症状,44例涂阴肺结核中,有症状者17例（38.6%）;活动性病灶、临床症状和最终确诊时间均大多发生在入看守所后26个月和612个月2个时间段内。结论看守所羁押人员结核病患病率显著高于社区,且症状不典型,存在延迟诊断的问题。