TB-SA抗体检测对结核病临床诊断价值的研究

目的　对TB-SA(Tuberculosis-Specific Antigen)抗体检测用于结核病诊断的价值进行评估。方法 2004年5—11月在山东省胸科医院住院的活动性结核病患者230例(菌阳肺结核60例,菌阴肺结核131例,肺外结核39例),非结核呼吸系统疾患者96例,无结核疾患的在校大学生健康志愿者41人,入选病例留取的痰、胸腔积液、腹腔积液、脑脊液标本同时进行抗酸杆菌浓缩集菌,结核杆菌培养,血清样本进行TB-SA抗体检测。结果 活动性结核病人血清学检测TB-SA抗体总的敏感性为67.8%。活动性肺结核敏感性为67.6%,肺外结核敏感性为59.0%(P>0.05);诊断结核病总的特异性为76.6%,在非结核呼吸系统疾患中为72.9%,在健康人群中为85.4%。结论 TB-SA抗体检测是一种快速、简单、有较好敏感性和特异性的结核病辅助诊断手段,对菌阴肺结核及不易取得细菌学检查标本的肺外结核病、儿童结核病有较高的参考价值。

Clinical value of TB-SA antibody in diagnosis of tuberculosis

Objective To evaluate the value of TB-SA(Tuberculosis-Specific Antigen) test in the diagnosis of tuberculosis.Methods 230 active tuberculosis patients(60 bacteriological-positive pulmonary patients,131 bacteriological-negative pulmonary patients,39 extra-pulmonary patients) and 96 non-tuberculosis respiratory system disease patients were recruited from May 2004 to November 2004 in Shandong Provincial Chest Hospital,and 41 healthy controls were from Shandong University,all specimens including sputum,pleural effussion,seroperitoneum, cerebrospinal fluid were submitted for Mycobacterium tuberculosis smear,culture,sera specimens from 367 cases were studied for TB-SA antibody by ELISA method.Results The total sensitivity of TB-SA test by ELISA serology method with sera from active tuberculosis patients was 67.8%,the sensitivities of subgroup of those with active pulmonary tuberculosis patients and extrapulmonary tuberculosis patients were 67.6% and 59.0%(P>0.05),respectively; the total specificity was 76.6%,the specificities of TB-SA test with sera from the no-tuberculosis respiratory system disease patients and healthy controls were 72.9% and 85.4%,respectively.Conclusions The TB-SA test was a kind of rapid,simple,relatively sensitive and specific method for diagnosis tuberculosis,especially in bacteriological-negative pulmonary tuberculosis,extra-pulmonary and childhood tuberculosis patients to aid in clinical decision making,which were hard to obtain specimens.