初治涂阳肺结核患者血清结核抗体IgG应用价值的再探讨  

Further discussion on clinical value of serum tuberculosis antibody IgG in the first-treated patients with smear-positive pulmonary tuberculosis

作　　者：钟红剑[1] 刘腊香[1] 朱飞 陈文胜[1] 文善适[1] 赵安贵[1] 

机构地区：[1]广东省深圳市宝安区慢性病防治院,深圳518133 [2]广东省深圳市宝安区龙华人民医院,深圳518100

出　　处：《中国防痨杂志》2010年第2期114-116,共3页Chinese Journal of Antituberculosis

摘　　要：目的探讨初治肺结核患者血清结核抗体(TB-Ab)IgG检测的临床应用价值和其影响因素。方法回顾性调查1 911例初治涂阳肺结核患者血清TB-Ab IgG阳性率,并与同期涂阴患者健康人群进行对照;观察血清TB-Ab IgG阳性率与病灶范围大小,有无空洞,是否排菌及排菌量多少的关系,将所得数据作统计学处理;同时观察血清TB-Ab IgG与结核纯蛋白衍化物皮肤试验(PPD)二者之间有无相关性。结果初治涂阳肺结核患者血清结核抗体阳性率仅53.3%,初治涂阴者为20.5%,健康人群血清结核抗体阳性率0.4%;初治涂阳患者血清TB-Ab IgG的阳性率与病灶范围大小,空洞有无及排菌量多少均有密切关系。结论血清TB-Ab IgG检测在肺结核患者中的特异性和敏感性值得商榷,其临床应用和诊断价值有待进一步完善和提高。Objective To reexplore the clinical value and influencing factors of serum tuberculosis antibody（TB-Ab） IgG in the first-treated patients with smear-positive pulmonary tuberculosis（TB）. Methods The positive rate of serum TB-Ab-IgG in 1 911 first-treated patients with smear-positive TB were analyzed retrospectively and were compared with healthy people of in the same period.The relationships between positive rate of serum TB-Ab-IgG and some clinical features including the size of lesion,cavity with or not,sputum smear-positive or negative,the amount of mycobecterium tuberculosis from sputum were studied.Data were analyzed by statistical software.The relationship between positive rate of serum TB-Ab-IgG and PPD results were also observed. Results The positive rate of serum TB-Ab-IgG in patients with smear-positive TB and,in patients with smear-negative and healthy people was 53.3%,20.5%,and 0.4%,respectively.The close relationships between the positive rate of serum TB-Ab-IgG and these clinical features including the size of lesion,cavity with or not,sputum smear-positive or negative,the amount of mycobecterium tuberculosis from sputum were found. Conclusions The specificity and sensitivity of serum TB-Ab-IgG in patients with smear-positive TB should be discussed and its clinical application and diagnostic value need to be improved.

关 键 词：结核 肺/免疫学 抗体 细菌 免疫球蛋白G 

分 类 号：R521[医药卫生—内科学] R392.4[医药卫生—临床医学]