联检TB-DNA、LAM-IgG和ADA诊断小儿结核性脑膜炎  

Combined detection of TB-DNA,LAM-IgG and ADA in CSF as a predictor to infantilie patients with tuberculous meningitis

作　　者：杨亚平[1] 杨桂梅[1] 丁晓旭[1] 朱长林[1] 杜新生[1] 薛承岩[1] 

机构地区：[1]河北省承德医学院附属医院,河北承德067000

出　　处：《中国医学工程》2007年第1期43-44,47,共3页China Medical Engineering

摘　　要：目的评价联检脑脊液结核杆菌DNA(TB-DNA)、抗阿拉伯糖甘露糖脂IgG抗体(LAM-IgG)和腺苷脱氨酶(ADA)指标诊断小儿结核性脑膜炎(结脑)及评价病情的价值。方法结脑组67例、非结核组38例,脑脊液标本应用聚合酶链反应法检测AFB、斑点免疫金渗滤试验法检测LAM-IgG、酶动力学终点法检测ADA。结果TB-DNA+LAM-IgG诊断结脑的特异性为100%、阳性率为86.1%。结脑病情进展,ADA呈升高趋势;病情好转,ADA呈下降趋势。结论在诊断结脑方面,TB-DNA+LAM-IgG联合试验的应用价值明显高于经典方法;在动态了解病情方面,ADA有较高的应用价值。三者联合应用可提高对小儿结脑诊断和评价的价值。[Objective] To evaluate the value on the combined detection of tuberculosis bacteria DNA （TB- DNA）, lipoarabinomannan G antibody （LAM-IgG） and adenosine deaminase （ADA） in cerebrospinal fluid for the diagnosis and the evaluation of infantilie tuberculous meningitis. [Methods] The objects were consisted of 67 infantilie patients with tuberculous meningitis and 38 infantilie patients with non-tubereulous central nervous system disease. AFB, LAM-IgG and ADA were detected by the polymerase chain reaction, the dot immunogold filtration assay and the end-point analysis respectively. [Results] The specificity and sensitivity of TB-DNA＋LAM-IgG were 100% and 85.1% respectively. ADA upturned when tuberculous meningitis developed while it was downwards when the disease recovered. [Conclusion] The applied value of the multi detection of TB-DNA＋LAM-IgG is much higher than classic methods. The detection of ADA has high value on observing disease dynamically. Combined test of these three indexes can improve the value of diagnosis and appraisal of infantilie tuberculosis meningitis.

关 键 词：结核性脑膜炎 脑脊液 结核杆菌DNA 抗阿拉伯糖甘露糖脂IgG抗体 腺苷脱氨酶 

分 类 号：R529.3[医药卫生—内科学] R446.14[医药卫生—临床医学]