结核菌脂多糖和酚提取蛋白在临床血清诊断中的应用  

The use of lipopoplysaccharides and phenol-extracted protein from Mycobacterium tuberculosis as antigens for serodiagnosis of tuberculosis

作　　者：李伏田[1] 徐小妹 景志春[1] 杨德燕 吕绳凯 

机构地区：[1]上海市遵义医院,200435 [2]上海市卫生防疫站 [3]上海市临床检验中心

出　　处：《上海医学检验杂志》1998年第4期207-208,共2页Shanghai Journal of Medical Laboratory Sciences

摘　　要：以结核菌脂多糖和酚提取蛋白为抗原，用ELISA方法对肺结核痰菌阳性患者、肺癌和老慢支患者、多菌型麻风患者和正常人进行了IgG抗体检测。抗脂多糖抗体和抗酚提取蛋白抗体测试的敏感度都是74．7％，特异性分别为97％和95％。两种测试的相关系数r=0．557。两者并联测定敏感度为85．3％，特异性为94％。如果将阳性判断标准设为两种测试全为阳性，或其中一项强阳性，则敏感度为72．6％，特异性达99％。因此，采用两种抗原作结核病血清诊断，能提高敏感度和特异性。Lipopolysaccharides (LPS ) and phenol extracted protein (P-P ) from Mycobacterium tuberculosis(H37Ra) are used as antigens in an indirect ELISA system. Serum antibodies to these antigens are assayedfor subjects including 95 cases of pulmonary tuberculosis with bacillary positive sputurn, 37 cases of lungcancer, 14 cases of chronic bronchitis, 40 cases of multibacillary leprosy and 100 normal subjects. Theserosensitivities of anti-LPS and anti-P-P antibodies are at the same percentage, i. e. 74. 7%. The serospecificities are 97% and 95%, respectively. The coefficient of correlation of the two assays is 0. 557. Bycombined analyses of two assays, the sensitivity raises to 85. 3%while specificity is 94%. If 2 times thevalue of cut-off level is taken to be the demarcation of strong positive (+ + ) and positive (+ ), 72. 6 % ofpatients with tuberculosis and 1 % of normal subjects show both assays (+ ) or either one of these 2 assays(++ ). It is suggested that two antigenic components to be used in serodiagnosis of tuberculosis compensate with each other, and raise the serosensitivity and specificity.

关 键 词：结核病 血清诊断 脂多糖抗原 蛋白抗原 

分 类 号：R520.4[医药卫生—内科学] R446.112[医药卫生—临床医学]