BCG多克隆抗体对麻风病诊断价值的探讨  

Diagnostic value of BCG poly-clonal antibody in leprosy

作　　者：何桥[1] 潘慧清[2] 马瑞琼[3] 邓晓华[1] 古聪敏[1] 刘燕[1] 

机构地区：[1]广州市胸科医院病理科,广州510095 [2]广东省皮肤病研究所病理室,广州510075 [3]广州市皮肤病防治所病理室,广州510095

出　　处：《诊断病理学杂志》2004年第6期392-394,I103,共4页Chinese Journal of Diagnostic Pathology

摘　　要：目的　探讨卡介苗 (BCG)多克隆抗体对麻风病的早期诊断、鉴别诊断及治疗效果评估的价值。方法　选择临床经组织学和细菌学检查确诊的麻风病患者 5 0例 ,可疑组 2 4例 ,治愈复查组 4 9例 ,对照组 2 1例 ,采用BCG多克隆抗体免疫组化染色技术检测各组中的BCG抗原 ;同时应用抗酸染色对确诊组进行麻风病原菌检查 ,并比较两种方法的优越性。结果　BCG阳性检出率确诊组 80 % (4 0 5 0 ) ,可疑组 5 4 2 % (13 2 4 ) ,治愈复查组 16 3% (8 4 9) ,对照组 9 5 % (2 2 1)。确诊组中的抗酸染色阳性病例数为 36例 ,阳性率为 72 %。另外 ,分析了确诊组中 以上的阳性检出率 ,BCG多克隆抗体检测法为 6 4 % (32 5 0 ) ,抗酸染色检测法为 4 8% (2 4 5 0 ) ,两者比较差异显著 (P <0 0 5 )。结论　BCG多克隆抗体免疫组化染色法优于抗酸染色 ,可用于对麻风病的早期诊断、鉴别诊断及治疗效果的评估 ,是一项操作简单 。Objective To study the value of BCG poly\|clonal antibody in early diagnosis, differential diagnosis and estimation of post\|therapeutic effect of leprosy. Methods 24 patients with negative acid\|fast staining in suspected group were atypical in clinical manifestation and histopathologic characteristics of leprosy; 49 used\|to\|be\|leprosy patients follow\|up group were negative in acid\|fast staining after DDS monotherapy or MDT combined chemotherapy; 50 leprosy patients group were confirmed by clinical manifestation, histology and bacteriology; 21 healthy people control group were not confirmed by clinical manifestation and histopathologic characteristics as leprosy patients. The BCG antigen in histologic specimen of all the patients was measured simultaneously by immunohistochemical staining and acid\|fast staining and the results were compared with each other. Results Positive reaction to BCG was presented in 13 cases among the suspected group (54 2%), 8 cases among the follow\|up group (16 3%), 40 cases among leprosy group (80%), 2 cases among control group (10%), whereas positive acid\|fast staining was presented in 36 cases among leprosy group (72%). Moreover, the positive rate higher than 4+ was 64% (32/50) in polyclonal antibody staining and 48% (24/50) in acid\|fast staining, in which significant difference existed ( P<0 05 ). Conclusion Immunohistochemical staining, by BCG poly\|clonal antibody, is superior to acid\|fast staining, and can be used in early diagnosis of leprosy, differential diagnosis and evaluation of therapeutic effect in leprosy. It is a simple but valuable test with high sensitivity.

关 键 词：BCG 麻风病 抗酸染色 多克隆抗体 确诊 对照组 诊断价值 组织学 细菌学检查 阳性率 

分 类 号：R755[医药卫生—皮肤病学与性病学] R446[医药卫生—临床医学]