三种结核分枝杆菌分泌抗原的血清学诊断价值  

The serodtagnostic value of antigens secreted from Mycobacterium tuberculosis

作　　者：王恩兰[1] 刘文涛[2] 李涛[1] 

机构地区：[1]安徽医科大学第一附属医院检验科,合肥230022 [2]中国科学技术大学生命科学学院

出　　处：《中华结核和呼吸杂志》2006年第7期466-469,共4页Chinese Journal of Tuberculosis and Respiratory Diseases

摘　　要：目的研究3种结核分枝杆菌分泌抗原(相对分子质量分别为81 000和38 000的抗原、CF-10抗原)在结核病血清学诊断中的价值。方法收集安徽省2002年3月至2005年4月结核病患者的血清标本149例,其中痰涂片阳性结核病患者108例,痰涂片阴性结核病患者41例;非结核性肺部疾病患者血清标本24例;健康对照170例。取指数生长中晚期结核分枝杆菌培养液,纯化38 000天然抗原,以和6个组氨酸融合的形式表达,镍离子螫合的层析柱亲和纯化81 000抗原和CF- 10抗原,通过酶联免疫吸附测定方法检测3种结核分枝杆菌分泌抗原的抗原性与特异性。结果纯化的抗原具备较高的纯度(>95％)和检测特异性(>98％)。结核病患者的81 000抗原、38 000抗原和CF-10抗原阳性检出率分别为64．4％(96／149)、57．0％(85／149)和37．6％(56／149),阴性符合率均大于98％。3种抗原联合使用对结核病患者的阳性检出率达到81．2％(121／149),阴性符合率大于98％。结论3种抗原均具有较好的特异性,3种抗原联合使用具有良好的敏感性与特异性,明显优于任何一种抗原单独使用的效果,将多个抗原联合使用是进行高质量的结核分枝杆菌血清学诊断切实可行的手段。Objective To study the serodiagnostic value of 3 antigens secreted from Mycobacterium tuberculosis： the 81 000 antigen, the 38 000 antigen and the CF-10 antigen, Methods The 38 000 antigen was purified from supernatant of exponential growth of Mycobacterium tuberculosis, The 81 000 antigen and CF-10 antigen were expressed by fusion with 6 histidine and purified by nickel chelate chromatographic column, Sera were obtained from 149 patients with tuberculosis （108 smear positive and 41 smear negative）, 24 patients with non- tuberculosis lung diseases and 170 healthy human controls in Anhui province from March 2002 to April 2005, Antigenicity and specificity of the 3 antigens were detected by enzyme-linked immunosorbent assay. Results Purified antigens had a high purity （ 〉 95% ） and a high specificity （ 〉98% ）. The positive rates of the 81 000 antigen, the 38 000 antigen and the CF-10 antigen in tuberculosis patients were 64, 4% （96/149）, 57, 0% （85/149） and 37.6% （56/149） respectively, The negative rates in nontuberculosis patient were all above 98%, The positive rate of the 3 antigens combined was 81.2% （121/149） and the negative rate was 98%, Conclusions The specificity of the 3 antigens was high. Sensitivity and specificity of the 3 antigens combined was better than each antigen alone. It is clinically practical that detection of multiple antigens may be used to improve the serodiagnosis of Mycobacterium tuberculosis.

关 键 词：分枝杆菌属 抗原 酶联免疫吸附测定 

分 类 号：R446.6[医药卫生—诊断学]