结核抗体蛋白芯片法对老年肺结核的诊断价值研究

目的探讨结核抗体蛋白芯片法对老年肺结核的诊断价值。方法选择93例肺结核及77例肺部非特异性感染老年患者,均行痰涂片抗酸染色试验,均采用结核分枝杆菌IgG抗体检测试剂盒(蛋白芯片)检测抗结核分枝杆菌脂阿拉伯甘露醇(LAM)、基因工程重组的16 kD和38 kD的IgG抗体,计算两种方法诊断结核分枝杆菌感染的敏感性及特异性;并分别构建受试者工作特征曲线,通过比较曲线下面积(area under the curve,AUC)评价其诊断效能。结果蛋白芯片法和痰涂片抗酸染色试验诊断结核分枝杆菌感染的敏感性分别为68.82%和33.33%,特异性分别为100.00%和97.40%;AUC分别为0.84和0.65,提示蛋白芯片法的诊断效能显著高于痰涂片抗酸染色法,差异有统计学意义(P0.01)。结论蛋白芯片法检测抗结核分枝杆菌LAM、16 kD和38 kD抗体快捷简便,对诊断老年肺结核有较高的实用价值。

Value of Tuberculosis Protein Chip Method in Diagnosis of Elderly Patients with Pulmonary Tuberculosis

Objective To investigate the value of tuberculosis protein chip method in diagnosis of elderly patients with pulmonary tuberculosis. Methods A total of 93 elderly patients with pulmonary tuberculosis and 77 patients with nonspecific lung infection were recruited in this study,and the antibodies of mycobacterium tuberculosis（ MTB） lipoarabinomannan（ LAM）and genetic engineering custom-crafted 16 kD and 38 kD-IgG were detected by using diagnostic kit for IgG antibody to mycobacterium tuberculosis and acid-fast staining test of sputum smear,The sensitivity and specificity of the two methods in diagnosis of mycobacterium tuberculosis infection were calculated respectively,and the receiver operating characteristic curves were built respectively,and then the diagnostic values were evaluated by comparing the areas under the curves（ AUC）. Results The sensitivity and specificity of tuberculosis protein chip method and acid-fast staining test of sputum smear in diagnosis of mycobacterium tuberculosis infection were 68. 82% 33. 33% and 100. 00% 97. 40% respectively; the AUC was 0. 84 and 0. 65 respectively,which showed that the diagnostic value of tuberculosis protein chip method was much better when compared with that of acidfast staining test of sputum smear,and the differences were of statistical significance（ P 〈0. 01）. Conclusion The tuberculosis protein chip method in detection of LAM,16 kD and 38 kD-IgG antibodies of mycobacterium tuberculosis is simple,quick and has significant practical value in diagnosis of elderly patients with pulmonary tuberculosis.