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1.
Demonstration of Mycobacterium tuberculosis in a smear or culture is the most reliable method for diagnosing tuberculosis (TB). In the last 10 years, several enzyme-linked immunosorbent assays (ELISAs) based on mycobacterial antigens (such as antigen 60, 38 kDa antigen, and antigen Kp90) have been used for the rapid diagnosis of TB. In this study, we report the isolation of an immunodominant lipopolysaccharide (LPS) antigen from M. tuberculosis H(37)Rv, which can be used for the serodiagnosis of TB. The LPS antigen was compared with three commercially available mycobacterium-specific antigens for the detection of TB. The antigens were evaluated using serum samples obtained from 59 Indian patients (19 patients with active pulmonary TB, 20 with extrapulmonary TB, and 20 with nontuberculous pulmonary disease) and 20 healthy adults. Antigen 60 IgG (sensitivity 89%, specificity 97%) and LPS (sensitivity 84%, specificity 97%) were more sensitive and specific than 38 kDa antigen IgG (sensitivity 79%, specificity 97%) and Kp90 IgA (sensitivity 82%, specificity 40%). These results indicate that the LPS antigen can be used as a sensitive tool for the serodiagnosis of TB and could be utilized to develop an ELISA for the screening of patients for TB.  相似文献   

2.
The usefulness of a new rapid diagnostic test (Patho-TB) using antibodies specific to mycobacterial antigens was evaluated for the rapid discrimination between pulmonary tuberculosis (TB) and non-TB pulmonary diseases on sputa. One hundred sputa collected from 79 active TB patients and from 21 patients with non-TB pulmonary diseases (asthma and chronic obstructive pulmonary disease) were enrolled into the study and tested for the presence of Mycobacterium tuberculosis by Ziehl–Neelsen smear, Patho-TB kit, and Löwenstein–Jensen culture. The sensitivity, specificity, positive predictive value, and negative predictive value of the Patho-TB test were 95%, 100%, 100%, and 84%, respectively. Patho-TB test is simple, quick, and easy to perform. Its sensitivity, specificity, and positive predictive value are satisfactory. Therefore, it could be used as a screening test in poorly equipped laboratories of TB endemic areas.  相似文献   

3.
徐烨  张红波  袁航 《疾病监测》2023,38(2):215-218
目的 探讨结核感染T细胞斑点试验(T-SPOT.TB)及外周血血小板计数(PLT)、血小板-淋巴细胞比值(PLR)对活动性肺结核与非活动性肺结核的鉴别意义。方法 回顾性分析宜春市人民医院2019年1月至2021年6月临床病例250例(活动性肺结核患者115例,非活动性肺结核患者63例,非结核性肺炎72例),收集其T-SPOT.TB试验结果、外周血白细胞计数、血小板计数、PLR、细菌抗酸染色等实验室结果和最终诊断,并做统计学分析。结果 非结核肺炎患者T-SPOT.TB阳性率为4.17%,明显低于非活动肺结核患者T-SPOT.TB阳性率(82.54%)和活动性肺结核患者T-SPOT.TB阳性率(85.22%);活动性肺结核组的血小板计数、PLR均高于非活动性肺结核组及非结核肺炎组。T-SPOT.TB、PLT、PLR多因素logistic回归分析表明,T-SPOT.TB联合PLT、PLR诊断活动性肺结核灵敏度为63.30%,特异度为86.50%。结论 T-SPOT.TB联合PLT、PLR有助于鉴别诊断活动性肺结核与非活动性肺结核,为临床提供是否抗结核治疗的依据。  相似文献   

4.
[目的]评价结核感染T细胞斑点试验(T-SPOT.TB)在诊断婴幼儿结核病(TB)中的临床应用价值.[方法]对2013年2月至2015年9月于本院就诊的118例3岁以内呼吸系统感染性疾病患儿行T-SPOT.TB、结核菌素试验(TST)和结核抗体(TB-Ab IgG)检测试验,比较这三种方法对TB诊断的特异性和灵敏度,评价应用T-SPOT.TB诊断活动性结核的价值.[结果]根据临床诊断标准,最终纳入婴幼儿结核感染组58例及非TB患儿对照组60例.T-SPOT.TB法诊断婴幼儿结核的敏感性和特异性分别为89.6%和93.3%,均高于TST(83.6%和66.7%)和TB-Ab IgG(65.5%和68.3%)检查,差异具有统计学意义(P<0.05).T-SPOT.TB的阳性预测值和阴性预测值也分别高于TST和TB-Ab IgG检测.[结论]外周血T-SPOT.TB对诊断婴幼儿结核具有较高的灵敏度和特异度,对婴幼儿结核感染的准确快速诊断具有重要的参考价值.  相似文献   

5.
Antibodies to two commercial extracts of Aspergillus fumigatus were determined by a class-specific enzyme-linked immunosorbent assay (ELISA) in 203 serum samples from 139 patients with various pulmonary diseases. In 22 patients with aspergilloma immunoglobulin (Ig)M, IgA, and especially IgG antibodies were found, whereas in 50 patients with allergic alveolitis IgG antibody was most frequent, IgM occurring rarely. One patient with allergic bronchopulmonary aspergillosis demonstrated IgG and IgA antibodies. Of 20 cases with bronchial asthma, 10% reacted against A. fumigatus in immunodiffusion as well as in ELISA. Of 46 cases with carcinoma, tuberculosis, and miscellaneous pulmonary diseases, 17% were positive by immunodiffusion and 26% demonstrated antibodies usually IgG, by ELISA. Of 100 healthy blood donors, none had Aspergillus antibodies of the IgG class, whereas 3% were positive in the IgM and 3% in the IgA assay. The ELISA proved to be sensitive and useful in the follow-up of patients with aspergilloma after operation.  相似文献   

6.
目的探讨结核蛋白芯片检测对诊断肺结核及肺外结核的价值。方法使用蛋白芯片系统检测血清结核抗体的病例共4765例,其中肺结核334例,肺外结核83例,肺结核并肺外结核69例,非结核病4279例。我们采用的蛋白芯片包含了结核分枝杆菌(MTB)中5种成分,即ESAT-6、CFP10、LAM、38KD和16KD。结果 334例肺结核中227例结核抗体阳性,83例肺外结核中50例阳性,69例肺结核并肺外结核中51例阳性,4279例非结核病797例阳性,结核蛋白芯片检测肺结核的阳性率为67.96%,肺外结核的阳性率为60.24%,肺结核并肺外结核的阳性率为73.91%,非结核病的阳性率为18.62%。结论结核蛋白芯片是对肺结核及肺外结核的辅助诊断有重要价值。但在淋巴结结核、结核性胸膜炎中阳性率偏低,敏感性稍差。  相似文献   

7.
Analysis of IgM/IgG/IgA antibody class activity to herpes simplex (HSV), measles and varicella zoster (VZV) antigen by indirect enzyme-linked immunosorbent assays has been applied to the cerebrospinal fluid and serum from 127 cases of focal encephalitis—39 patients with and 88 patietns without biopsy/necropsy.Results indicative of herpes etiology were found in 53 cases. Intrathecal antibody production was found in all CSF samples taken beyound the tenth day after the onset of neurological illness with one exception—a boy treated with acyclovir for a primary infection within 20 hours after the onset of illness. Intrathecal HSV antibody response was of IgG class in 94%, IgM class in 70% and IgA in 94%.In primary infections, the HSV IgM CSF response was high and contributed to an early diagnosis; in recurrent infections it was often at a low level and late. HSV IgM persisted from 60 to 328 days, IgG and IgA during observation times to 678 days. Cross-reactivity with varicellae zoster was found to be restricted to IgG only.  相似文献   

8.
目的探讨神经梅毒患者血清及脑脊液免疫学诊断特点。 方法选取2013年6月至2016年7月首都医科大学附属宣武医院收治的35例神经梅毒患者,其中32例患者行血清与脑脊液免疫学指标检测,回顾性分析35例患者的检查结果,应用Fisher精确检验比较血清组与脑脊液组IgA、IgM的差异,应用卡方检验比较血清组与脑脊液组IgG的差异,并对脑脊液寡克隆条带阳性检出率和脑脊液24 h IgG合成率进行分析。 结果32例神经梅毒患者检测血清免疫球蛋白,有53.13%(17/32)的患者IgG升高,6.25%(2/32)的患者IgA升高,0%(0/32)的患者IgM升高;脑脊液中,有84.38%(27/32)的患者IgG升高,100.00%(32/32)的患者IgA升高,90.63%(29/32)的患者IgM升高;血清与脑脊液IgA、IgM升高率比较,差异有统计学意义(P<0.01),IgG升高率比较,差异无统计学意义(χ2=7.27,P>0.05)。25例神经梅毒患者行CSF寡克隆电泳,IgG寡克隆条带阳性率为100.00%(25/25),96.00%(24/25)患者脑脊液24 h IgG合成率升高。 结论神经梅毒临床表现多样,是易误诊的可治性疾病。血清及脑脊液IgG多表现为升高,脑脊液IgA、IgM多表现为升高而血清IgA、IgM多表现为正常,脑脊液寡克隆条带阳性,脑脊液24 h IgG合成率升高等免疫学特点对神经梅毒诊断有意义。  相似文献   

9.
腰椎间盘突出症影像学表现与免疫学的相关研究   总被引:2,自引:0,他引:2  
目的:探讨腰椎间盘突出症的免疫状态及其影像学表现与免疫水平的关系。方法:分析了52例腰椎间盘突出症的影像学表现,检测了其血清IgG、IgM、IgA、C3和C4水平,并与40例正常组行对照研究。结果:(1)影像学表现分突出型(12例,占23.1%);破裂型(28例,占53.8%)和游离型(12例,占23.1%)。(2)腰椎间盘突出症血清IgM、IgG较对照组高。(3)破裂型组较对照组血清IgG、IgM水平增高,此外,游离型组血清IgA水平亦同时增高,而突出型组无意义。结论:腰椎间盘突出症存在体液免疫反应的异常,提示临床上腰腿痛病人,若血清IgG、IgM升高或IgG、IgM、IgA同时升高,对辅助诊断腰椎间盘突出破裂型或游离型能提供更多有价值的信息。  相似文献   

10.
乙肝大三阳患者肝细胞损伤与6项免疫指标相关性探讨   总被引:1,自引:0,他引:1  
目的探讨乙型肝炎大三阳患者肝细胞损伤与血清IgM、IgG、IgA、C3、C4及C反应蛋白(CRP)变化的关系。方法选择乙肝大三阳患者80例,根据丙氨酸氨基转移酶(ALT)值(ALT>200IU/L和<40IU/L)分为甲、乙两组,各40例,采用速率散射比浊法测定血清IgM、IgG、IgA、C3、C4及CRP。结果甲组血清IgA、IgG、CRP均高于乙组,两组差异具有统计学意义(P<0.05);血清IgM、C3、C4两组差异无统计学意义(P>0.05)。结论血清IgA、IgG、CRP有助于评估肝细胞损伤程度。  相似文献   

11.
目的 探讨各种肾病患者血清免疫球蛋白及补体检测的意义.方法 采用速率散射浊度法检测急性肾炎(AN)、慢性肾炎(CN)、肾病综合征(NS)、尿毒症(UR)患者及健康对照(normal)者血清免疫球蛋白(IgG、IgA、IgM)和补体(C3、C4)水平. 结果 (1)各种肾病组IgG均有不同程度的降低,各项指标降低程度各组...  相似文献   

12.
目的 探讨血清免疫球蛋白IgA,IgM和IgG检测在慢性乙型肝炎(chronic hepatitis B,CHB)和乙肝肝硬化(chepatitis B cirrhosis,HBC)中的临床意义。方法 选取2017年1月~2018年3月在西安市中心医院治疗的CHB患者80例和HBC患者78例(代偿期55例和失代偿期23例)作为研究对象,另选取同期健康体检者80例作为对照组,应用免疫散射比浊法检测各组血清IgA,IgM和IgG水平。结果 CHB组血清IgA和IgG水平显著高于对照组,HBC组血清IgA,IgM和IgG水平显著高于对照组,HBC组血清IgA和IgG水平显著高于CHB组,差异具有统计学意义(t=2.009~6.804,均P<0.05)。肝硬化失代偿期组血清IgA水平显著高于代偿期组,差异具有统计学意义(t=2.333,P<0.05)。结论 血清免疫球蛋白检测对于CHB和HBC患者的病情判断、临床治疗及预后评估具有重要的临床意义。  相似文献   

13.
The aim of this study was to evaluate the diagnostic value of tests detecting antibodies against lipoarabinomannan (LAM), 38-kDa, and 16-kDa antigens for Mycobacterium tuberculosis (MTB). Sera from 160 tuberculosis (TB) patients and 150 non-TB healthy controls were subjected to simultaneous detection of antibodies against LAM, 38-kDa, and 16-kDa antigens using protein chips. The diagnostic value of the 3 TB antigens, alone or combined, was evaluated. Results showed that LAM and 38-kDa antigens had the highest positive rates in the TB patients. Tests showing any single positive antibody, 2 positive antibodies, and 3 positive antibodies had a sensitivity of 93.1%, 51.3%, and 15.6%, and a specificity of 81.3%, 96.6%, and 99.3%, respectively. The positive predictive value of tests showing any 2 positive antibodies and 3 positive antibodies was 94.2% and 96.1%, respectively. Combined detection of a selected panel of TB antibodies can improve the positive rates for TB diagnosis and can serve as an important aid to the diagnosis of TB especially extrapulmonary TB.  相似文献   

14.
【目的】探讨免疫相关指标及核抗原(ENA)抗体在系统性红斑狼疮(SLE)患者中的诊断价值。【方法】SLE患者80例,根据患者病情分为活动期组(35例)和非活动期组(45例)。选取健康志愿者40例作为对照组。检测比较三组对象外周血免疫相关指标(IgA、IgM、IgG、C3、C4)以及ENA抗体(抗ds-DNA、抗Sm、抗SSA、抗SSB、抗u1RNP)水平的差异。使用ROC曲线分析相关指标对活动期SLE的诊断价值。【结果】三组间IgA、IgM、C3、C4、IgG、抗ds-DNA、抗Sm、抗SSA、抗SSB、抗u1RNP差异均具有统计学意义(P<0.05)。活动期组患者IgA、IgM、IgG分别高于对照组、非活动期组,C3、C4分别低于对照组、非活动期组,且差异有显著性(P<0.05);非活动期组IgA、IgG高于对照组,C3低于对照组(P<0.05)。活动期组、非活动期组患者抗ds-DNA、抗Sm、抗SSA、抗SSB、抗u1RNP阳性率高于对照组,且差异有显著性(P<0.05);非活动期组、活动期组间各ENA抗体阳性率相比较差异无显著性(P>0.05)。IgA诊断活动期SLE的最佳临界点为4.5g/L。当IgA为4.5g/L时,IgA诊断活动期SLE的灵敏度为71.5%,特异度为80.1%;AUC曲线下面积为0.81。【结论】免疫相关指标及ENA抗体在SLE患者中诊断价值较高,且IgA、IgG及C3能较好提示病情进展情况。  相似文献   

15.
目的 探讨住院儿童呼吸道合胞病毒(RSV)感染血清特异性抗体IgM,IgG和IgA表达的相关性,筛选具有早期辅助诊断意义的抗体指标。方法 运用荧光定量聚合酶链反应技术(FQ-PCR)筛选出2015~2017年50例咽拭子RSV阳性的住院患儿; 采用酶联免疫吸附试验(ELISA)检测患儿血清中的特异性抗体IgM,IgG和IgA; 同时以95例无呼吸道感染症状的儿童血清标本作为对照组; 采用卡方检验对结果进行统计学分析。结果 50例咽拭子RSV阳性患儿血清中IgM,IgG,IgA及三者同时出现阳性率分别为24.00%,60.00%,22.00%%和16.00%,差异有统计学意义(χ2=28.19,P<0.01); 同一性别患儿的IgM,IgG和IgA阳性率在实验组和对照组中差异有统计学意义(χ2=9.16,P<0.01),不同性别在同一实验组或对照组中各抗体阳性率差异无统计学意义(χ2=0.10,P>0.05); 急性喉气管支气管炎中未检出IgM,IgG和IgA,仅在急性上呼吸道感染中检测到1例IgG,支气管肺炎及急性支气管炎中以IgG的检出率41.38%和23.53%最高,且均未单独检测到IgA; <6个月年龄组患儿在7天和21天内均未检出IgM和IgA,1~5岁年龄组患儿在7天内产生IgM阳性率为50.00%最高,且在21天内均能检出IgM,IgG和IgA,5~10岁年龄组患儿在7天内产生IgG和IgA的阳性率为100%和66.67%。结论 RSV特异性抗体IgM,IgG和IgA不能单独作为早期感染RSV的诊断指标,特异性抗体产生不受性别因素影响,上呼吸道感染RSV较难产生IgM,IgG和IgA,患儿年龄越小产生IgM和IgA的速度越慢,同时IgG存在母婴垂直传播且对机体无保护作用,RSV感染人体引起临床呼吸道症状可能与自身免疫力有关; IgA产生最早且不单独出现。  相似文献   

16.
刘玉华  张素平  邓婉青 《临床荟萃》2004,19(13):745-747
目的 探讨结核性脑膜炎、病毒性脑膜炎、急性播散性脑脊髓炎脊液铁蛋白、脑脊液白蛋白 /血清白蛋白比值及脊液免疫球蛋白的变化及诊断意义。方法 检测结核性脑膜炎 31例、病毒性脑膜炎 32例、急性播散性脑脊髓炎 30例患者的脑脊液铁蛋白、脑脊液白蛋白 /血清白蛋白比值及脊液免疫球蛋白的变化 ,并与 30例正常者作对照。结果 方差分析显示结核性脑膜炎、病毒性脑膜炎、急性播散性脑脊髓炎及对照组脑脊液铁蛋白、脑脊液白蛋白 /血清白蛋白比值差异均有统计学意义 (P <0 .0 0 0 1) ,3组脑部疾病间的铁蛋白、脑脊液白蛋白 /血清白蛋白比值差异均有统计学意义 (P均 <0 .0 5 )。方差分析结核性脑膜炎、病毒性脑膜炎及急性播散性脑脊髓炎脑脊液IgA、IgM、IgG变化差异有统计学意义 (P <0 .0 0 0 1) ,结核性脑膜炎组脑脊液IgA、IgM较急性播散性脑脊髓炎及病毒性脑膜炎显著升高(P <0 .0 5 ) ,急性播散性脑脊髓炎IgG较结核性脑膜炎及病毒性脑膜炎显著升高 (P <0 .0 5 )。结论 结核性脑膜炎、病毒性脑膜炎、急性播散性脑脊髓炎脊液铁蛋白、脑脊液白蛋白 /血清白蛋白比值和脊液免疫球蛋白的变化和差异 ,可作为诊断和鉴别诊断的参考指标。  相似文献   

17.
目的探讨抗核抗体荧光模式及滴度与免疫球蛋白及补体的关系。方法采用透射比浊法对768例抗核抗体阳性患者血清进行免疫球蛋白及补体检测,另选取200名健康体检者作为对照组。根据抗核抗体荧光模式及滴度进行分组,分别研究各组免疫球蛋白及补体水平。结果①抗核抗体滴度≥1∶100时,血清IgG、IgA明显升高(P<0.01),但升高的幅度与抗核抗体滴度无明显相关;IgM和C3、C4只有在抗核抗体滴度≥1∶1 000时才分别显著升高和下降(P<0.01)。②各种单荧光模式型患者血清IgG、IgA、IgM、C3、C4浓度无显著差异;与各单荧光模式患者比较,二联及二联以上荧光模式型患者血清IgG、IgA、IgM显著升高、补体C3、C4水平显著下降(P<0.01)。结论抗核抗体、免疫球蛋白及补体虽然与自身免疫性疾病高度相关,但并不与病情成平行关系,三项联合检测才能对疾病的诊断与病情发展作出正确判断。  相似文献   

18.
BACKGROUND/PURPOSE: The purpose of this study was to determine serum antibody titers against a common bacterial antigen, Helicobacter pylori (H. pylon), in subjects with sarcoidosis, comparing those titers to those present in a healthy population. SUBJECTS AND METHODS: With the approval of the Institutional Review Board of the University of Missouri-Kansas City, patients with sarcoidosis (pulmonary and extrapulmonary) who visited the Truman Medical Center-Hospital Hill pulmonary clinic were recruited to enter the study. A serum sample was frozen at -70 degrees C for later testing (n = 20). Specific information collected on subjects included corticosteroid use, use of histamine2 blockers and antacids, date of first diagnosis, and stage of sarcoidosis. Normal controls and demographically matched individuals who lacked pulmonary diseases, including sarcoidosis, were also recruited. Serum samples were processed as above. Antibody capture enzyme immunoassay was completed for H. pylori and urease antigens by serum dilution assay for each subject, from which titers for antigen-specific immunoglobulin (Ig)G and IgA were calculated. Nonspecific serum IgE was also measured. RESULTS: An increased incidence of high-titer IgG antibody directed against H. pylori antigens was found in subjects with sarcoidosis compared with controls. The sarcoidosis and control groups were significantly different with respect to IgG and IgA against H. pylori, both at p = .001. IgG directed against urease was also significantly different between sarcoidosis and control patients (p = .001), but IgA directed against urease was very low in all subjects and did not yield significant differences between groups. CONCLUSIONS: Specific H. pylori and urease IgG antibodies exceeded those expected in the population studied. The data suggest that in pulmonary sarcoidosis, the relationship of H. pylori and its products to sarcoid granuloma formation warrants further investigation.  相似文献   

19.
The intestinal clearance of alpha 1-antiproteinase, monomeric IgA and IgG, and the daily fecal output of polymeric IgA and IgM were investigated in patients with inflammatory bowel diseases (inactive and active Crohn's disease, ulcerative colitis) and in a control group. The intestinal clearance of alpha 1-antiproteinase was significantly increased in all patients with inflammatory bowel diseases (p less than 0.01), irrespective of the grade of the disease. In contrast, increases in intestinal clearances of monomeric IgA and IgG were more closely related to the severity of the intestinal lesions. The associate determination of these three quantities should therefore be of interest for monitoring the degree of intestinal bowel inflammation. Faecal output of polymeric IgA was significantly increased in active intestinal disease (p less than 0.01), whereas faecal IgM levels were not. The determination of the faecal output of polymeric IgA should contribute to the assessment of the activity of inflammatory bowel diseases, and may provide insight into the activation of the mucosal immune system.  相似文献   

20.
目的 评价Trustline结核抗体IgG/IgM检测试剂盒临床应用效果。 方法 选用3家医院的1009份血清标本,其中628份为结核病患者血清(308例菌阳病例,320例菌阴病例);对照组381份非结核病血清。采用Trustline试剂盒及一种已上市的试剂盒(对照试剂盒)分别检测1009份血清,计算多项检测指标,从而评价试剂盒的检测效果。 结果 通过检测1009份临床血清标本, Trustline试剂盒检测血清抗体(IgG+IgM)的灵敏度、特异度、阳性预测值、阴性预测值、 Youden 指数分别为61.3%、79.8%、 83.3%、 55.6% 和0.411,对照试剂盒检测血清抗体(IgG) 的结果分别为53.7%、89.0%、88.9%、 53.8%和0.426。经统计分析表明Trustline试剂盒的灵敏度显著优于对照试剂盒(P0.01),特异度低于对照试剂盒(P0.01),但阳性诊断效率和阴性诊断效率方面差异无统计学意义,Youden指数相接近。 进一步分析显示Trustline试剂盒对菌阳样本及菌阴样本的检出率分别77.6%和44.7%,对照试剂盒则为67.9%和40.0%,对菌阳样本检出率的差异有统计学意义。检测1009份标本,Trustline试剂盒共得IgM阳性35例,其中结核组阳性30例(4.8%),非结核组阳性5例(1.3%)。 结论 Trustline试剂盒检测结核抗体的灵敏度显著优于对照结核抗体试剂盒,并可同时用于检测IgG/IgM抗体,可以应用于结核病的快速诊断。  相似文献   

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