蛋白芯片法检测结核抗体在活动性结核病的诊断价值

目的:评价蛋白芯片法检测结核抗体对结核病的诊断价值。方法:采用蛋白芯片法对163例痰涂片阴性的肺结核患者、156例肺外结核患者及95例非结核病变患者血清标本进行检测,并对上述所有病例同时行PPD试验。结果:PPD试验对诊断结核病的敏感性为55.8%,特异性为62.3%,蛋白芯片法对诊断结核病的敏感性为60.5%,特异性为95.8%。肺结核患者与肺外结核患者PPD试验结果相比差异无统计学意义(P>0.05),肺结核患者与肺外结核患者蛋白芯片法检测结果相比差异有统计学意义(P<0.05)。PPD试验与蛋白芯片法联合检测阳性率为74.9%,优于单一的PPD试验或蛋白芯片法(P<0.05),差异有统计学意义。结论:蛋白芯片法诊断结核病特异性高,联合PPD试验具有较高的诊断价值,可以作为诊断结核病,特别是肺外结核病的重要辅助诊断方法。

Evaluation of detection of anti-mycobacteriun tuberculosis antibodies by protein chip technology in diagnosis of tuberculosis

Objective To evaluate the significance of the protein chip technology in the diagnosis of tuberculosis.Method Three antibodies against mycobacteriun tuberculosis antigens（16 KDa,38 KDa and LAM） were detected in the serum samples from 319 cases of tuberculosis and 95 patients with non-tuberculosis diseases,and all cases were studied by PPD-test.Results The sensitivity of PPD test was 55.8% in TB,while the specificity was 62.3%.The protein chip technology showed a sensitivity of 60.5%,with a specificity of 95.8%.The difference between pulmonary tuberculosis group and extrapulmonary tuberculosis group was not significant（P0.05）,while the difference between pulmonary tuberculosis group and extra-pulmonary tuberculosis group was significany（P0.05）.A combination of both tests showed a positive rate of 74.9%.Compared with PPD test or the protein chip technology,the positive rate of the combined measurement of two methods was significantly higer than PPD test or the protein chip technology.Conclusion The protein chip technology has high specificity.Combined measurement of protein chip technology and PPD test leads to an increase in the diagnostic accuracy of TB.