儿结核病结核抗体检测的诊断价值

目的：探讨结核菌纯蛋白衍化物(PPD)及抗脂肪阿拉伯酸甘露聚糖抗体(LAM-IgG)对小儿结核病的诊断价值。方法：检测66例结核病患儿血清抗LAM-IgG和PPD试验，并与30例非结核病患儿进行对照。结果：小儿结核病PPD试验阳性率为59.1%，抗LAM-IgG阳性率为69.7%，两者差异无显著性(P＞0.05)。PPD试验对非重症结核病阳性率(79.5%)明显高于重症结核(18.2%)(P＜0.005)；而抗LAM-IgG重症结核病阳性率(70.5%)与非重症结核病(68.2%)相近(P＞0.05)。PPD试验对非结核病患儿的假阳性率(36.7%)明显高于抗LAM-IgG试验(3.3%)(P＜0.01)。结论：PPD试验对非重症结核病诊断价值优于重症结核病；抗LAM-IgG检测对重症结核病的诊断优于PPD试验，对非结核病的假阳性率较低。

Diagnostic value of tuberculin test and anti-lipoarabinomannan IgG in tuberculous children

Objective:To explore diagnostic value of purified protein derivative(PPD) test and detection of anti lipoarabinomannan IgG(anti LAM IgG) in tuberculous children.Methods:PPD test and anti LAM IgG detection were used in 66 tuberculous children and 30 non tuberculous children.Results:The positive rate of PPD tests in tuberculous was 59.1% and that of anti LAM IgG was 69.7%.The difference between these 2 methods were not significant( P >0.05),the positive rate(79.5%) of PPD in less severe cases was much higher than that(18.2%) in severe cases( P <0.005).The positive rate(70.5%) of anti LAM IgG in severe tuberculosis was similar to that(68.2%) of less severe tuberculosis( P >0.05).The false positive rate(36.7%) of PPD was much higher than that(3.3%) of anti LAM IgG( P <0.01) in patients without tuberculosis.Conclusions:Diagnostic value of PPD test in less severe tuberculosis is better than that of severe tuberculosis,diagnostic value of anti LAM IgG is better than that of PPD test in severe tuberculosis and the false positive rate is low in patients without tuberculosis.