脑脊液单核细胞内ESAT-6检测对结核性脑膜炎的诊断意义

目的评价检测脑脊液中单核细胞内的早期分泌性抗原靶6(ESAT-6)对结核性脑膜炎诊断的意义,为结核性脑膜炎的诊断提供有效的方法。方法将20例结核性脑膜炎患者与20例对照组患者进行脑脊液常规、生化、细胞学检查,同时用免疫组化的方法检测脑脊液单核细胞内的ESAT-6及PPD。结果结核性脑膜炎患者单核细胞内存在ESAT-6,在20例结核性脑膜炎患者中14例显示阳性,对照组中1例阳性,结核性脑膜炎组单核细胞内ESAT-6阳性检出率显著高于对照组,(P<0.05),该方法诊断结核性脑膜炎敏感性为70%,特异性为95%,约登指数0.65。结核性脑膜炎组单核细胞内PPD阳性检出率显著高于对照组,(P<0.05),敏感性为0.65,特异性为0.90,约登指数为0.55。结论检测脑脊液单核细胞中ESAT-6是诊断结核性脑膜炎的一种简便、特异的方法 。

The value of the ESAT-6 detection in the monocytes of CSF in diagnosis of tuberculous meningitis

Objective To evaluate the significance in diagnosis of tuberculous meningitis by detecting ESAT-6 in the monocytes of CSF.Methods The 20 patients with clinical diagnosis of tuberculous meningitis,and 20 patients of disease control were investigated of CSF the routing test,biochemical,cytology（MGG dye）,Alixin dye.Immunohistochemistry demonstration of ESAT-6 and PPD in the cytoplasm of monocytes were carried out at the same time.Results The ESAT-6 in the plasma of the monocytes of CSF.In 20 patients of tuberculous meningitis,14 showed positive immunohistochemistry,while only one showed positive in the control group.The positive rate of ESAT-6 in experimental group was significantly higher than the control group（P0.05）,its sensitrity was 70%,and specifity was 95%,youdens index was 0.65.The positive rat of PPD in experimental group was significantly higher than the control group.Its sensitivity is 65%,and specificity is 90%,youdens index is 0.55.Conclusion The ESAT-6 detection in the monocytes of CSF is a simple and specific method in diagnosis of tuberculous meningitis