结核分枝杆菌Ag85A和Ag85B蛋白在结核病诊断的价值

目的探讨重组结核分枝杆菌Ag85A和Ag85B蛋白用于结核病的诊断价值。方法以Ag85A和Ag85B为抗原,PPD为对照,用ELISA法检测血清中特异性抗结核抗体。结果 325例肺结核病组,Ag85A、Ag85B和PPD检测的灵敏度分别为58.2%、62.2%和71.7%。健康献血组、非结核性呼吸疾病组和卡介苗接种阳转组血清同时用Ag85A、Ag85B和PPD检测,Ag85A特异性分别为94.3%、93.0%、73.7%。Ag85B特异性分别为96.4%、96.5%、85.3%。PPD特异性为93.6%、86.0%、67.9%。统计分析显示,Ag85B蛋白和PPD检测非结核性呼吸疾病组,其特异性有显著性差异（P〈0.05）。检测卡介苗接种阳转组阳性率和血清抗体滴度有显著性差异（P〈0.05）。Ag85A和Ag85B同时检测325例肺结核病组血清可显著提高检测的阳性率。结论 Ag85B蛋白抗原有较好的灵敏度和较高特异性,是ELISA的可靠抗原,与Ag85A联用可提高灵敏度,对结核病血清学诊断有较高参考价值。

Value of detection of recombinant Ag85A and Ag85B antigen of Mycobacterium tuberculosis in diagnosis of tuberculosis

Aim To assess the value of detection of recombinant Ag85A and Ag85B protein of Mycobacterium tuberculosis in diagnosis of tuberculosis patients.Methods The purified Ag85A and kg85B were used to detect sera antibodies using enzyme-linked immunosorbent assay（ELISA）,and the PPD was used as control.Results The sensitivity of Ag85A,Ag85B and PPD In detecting the sera of 325 pulmonary tuberculosis patients were 58.2%、62.2%and 71.7% respectively.The specificity of Ag85A、Ag85B and PPD in detecting serum samples of healthy controls,non-tuberculosis respiratory patients BCG vaccinated healthy controls were 94.3%,93.0%,73.7%;96.4%,96.5%,85.3%and 93.6%,86.0%, 67.9%,respectively.The specificy of Ag85B was significant higher than that of PPD in detecting the sera of non-tuberculosis respiratory patients and BCG vaccinated healthy controls（P0.05）.The positive rates of antibodies to Ag85 A and Ag85B in serum sera of 325 pulmonary tuberculosis patients by simultaneous detection with Ag85A and Ag85B as antigens could be markedly enhanced.Conclusion Ag85B,which can provide a satisfactory sensitivity and specificity,may become effective antigen in ELISA and combined use of Ag85A and Ag85B allow improvement etection sensitivity.