4种靶特异性抗体检测对肺结核的临床诊断价值

目的:探讨4种靶特异性抗原结核抗体对肺结核的临床诊断价值。方法:选取分别含LAM、38ku/16ku蛋白、纯化BCG蛋白、人型PPD的4种结核抗体检测试剂盒,对110例肺结核、100例对照标本进行测定,运用卡方(χ2)检验,比较各组间敏感性、特异性的差异。结果:LAM-IgG、38ku/16ku-IgG、BCG-IgG和PPD-IgG的敏感性分别为74.5%、70.9%、80.0%和83.6%;特异性分别为91.0%、99.0%、93.0%和84.0%;痰菌阳性的阳性检出率分别为85.7%、88.6%、91.4%和91.4%;痰菌阴性的阳性检出率分别为69.3%、62.7%、74.7%和80.0%。结论:4种靶特异性抗原结核抗体对肺结核诊断的敏感性无显著差异,特异性存在非常显著的差异;以PPD为靶抗原的国产结核抗体试剂盒价格低廉,有很高的敏感性和较高的特异性,适宜推广使用。

Four target specific antigens:Diagnostic value in detecting the antibody of pulmonary tuberculosis

Objective:To evaluate the diagnostic value of 4 kinds of target specific antigen in detecting the antibody of pulmonary tuberculosis.Methods:Four reagent kits contained lipoarabinomannan(LAM),protein of 38 ku/16 ku and purified BCG and human PPD were used to detect the tuberculous antibodies in 110 patients with pulmonary tuberculosis and another 100 subjects were employed as controls,with comparison of the differences between the two groups in sensitivity and specificity by Chi-square test.Results:The sensitivity from LAM-IgG,38 ku/16 ku-IgG,BCG-IgG and PPD-IgG was 74.5%,70.9%,80.0% and 83.6%,and the specificity to the corresponding factors was 91.0%,99.0%,93.0% and 84.0%,respectively.The prevalence rate of smear positive pulmonary tuberculosis was 85.7%,88.6%,91.4% and 91.4% compared to 69.3%,62.7%,74.7% and 80.0% in negative cases,respectively.Conclusion:The 4 target specific antigens in detecting the antibody of pulmonary tuberculosis suggest no significant difference in sensitivity,but are greatly different in specificity.The domestic target antigen on basis of human PPD might be preferable in clinic use for its cheap price and high sensitivity and specificity.