脑脊液中检测结核分枝杆菌特异性抗原对结核性脑膜炎的诊断意义

目的 应用改进的斑点酶联免疫吸附法(Dot ELISA)检测脑脊液中结核分枝杆菌特异性抗原培养滤液蛋白10(CFP10)和6000早期分泌性抗原靶(ESAT-6),评价其在结核性脑膜炎(TBM)中的诊断价值.方法 收集111例患者的脑脊液,其中58例临床诊断为TBM,53例非TBM,应用Dot ELISA法分别检测脑脊液中CFP10和ESAT-6并进行分析.结果 检测CFP10抗原的敏感度为93.1%,特异度为92.5%;检测ESAT-6抗原的敏感度为91.4%,特异度为94.3%.两项检测的敏感度和特异度均普遍高于针对结核分枝杆菌菌体或菌体物质进行检测的同类研究,如抗酸染色、结核分枝杆菌培养、聚合酶链反应等.结论 应用改进的Dot ELISA法检测脑脊液中CFP10和ESAT-6对诊断TBM有很高的敏感度和特异度,为结核分枝杆菌特异度抗原用于临床结核病诊断提供了依据.

Abstract：

Objective To evaluate the detection of culture filtrate protein 10 (CFP10) and 6000 early secretory antigenic target (ESAT-6) in cerebrospinal fluid to be used in diagnosing tuberculous meningitis. Methods Dot enzyme linked immunosorbent assay ( Dot ELISA) method that was improved by applying concentrated cerebrospinal fluid was used to detect CFP10 and ESAT-6 in cerebrospinal fluid to analyze small protein antigen secreted by M. tuberculosis. Cerebrospinal fluid of 111 subjects were collected,in which 58 specimens were clinically diagnosed as tuberculous meningitis and 53 as non-tuberculous.CFP10 and ESAT-6 were detected in cerebrospinal fluid using Dot ELISA method and the results were analyzed. Results The sensitivities of detecting CFP10 and ESAT-6 antigen were 93.1% and 91.4% respectively, and the specificities were 92. 5% and 94. 3% respectively. The sensitivities and specificities are generally higher compared with the other methods of detecting M. tuberculosis or materials of M. tuberculosis by acid-fast staining or mycobacterium tuberculosis culture and polymerase chain reaction.Conclusions Using Dot ELISA method to detect CFP10 and ESAT-6 in cerebrospinal fluid to diagnose tuberculous meningitis has a high sensitivity and specificity. Our study provided the evidence of detecting the specific antigen of M. tuberculosis to be used in diagnosing tuberculosis.

The significance in diagnosing tuberculous meningitis by detecting specific antigen in cerebrospinal fluid

Objective To evaluate the detection of culture filtrate protein 10 (CFP10) and 6000 early secretory antigenic target (ESAT-6) in cerebrospinal fluid to be used in diagnosing tuberculous meningitis. Methods Dot enzyme linked immunosorbent assay ( Dot ELISA) method that was improved by applying concentrated cerebrospinal fluid was used to detect CFP10 and ESAT-6 in cerebrospinal fluid to analyze small protein antigen secreted by M. tuberculosis. Cerebrospinal fluid of 111 subjects were collected,in which 58 specimens were clinically diagnosed as tuberculous meningitis and 53 as non-tuberculous.CFP10 and ESAT-6 were detected in cerebrospinal fluid using Dot ELISA method and the results were analyzed. Results The sensitivities of detecting CFP10 and ESAT-6 antigen were 93.1% and 91.4% respectively, and the specificities were 92. 5% and 94. 3% respectively. The sensitivities and specificities are generally higher compared with the other methods of detecting M. tuberculosis or materials of M. tuberculosis by acid-fast staining or mycobacterium tuberculosis culture and polymerase chain reaction.Conclusions Using Dot ELISA method to detect CFP10 and ESAT-6 in cerebrospinal fluid to diagnose tuberculous meningitis has a high sensitivity and specificity. Our study provided the evidence of detecting the specific antigen of M. tuberculosis to be used in diagnosing tuberculosis.