直接检测痰标本中MPB64蛋白在结核病诊断中的临床应用价值  

Diagnostic value of directly detecting MPB64 protein in sputum sample in tuberculosis

作　　者：孟繁荣[1] 谢贝[1] 郑小凌[1] 尹小毛[1] 蔡杏珊[2] 许婉华[3] 彭湘明[4] 赖艳榕[4] 刘志辉[1] 

机构地区：[1]广州市胸科医院肺部疾病研究所,510095 [2]广州市胸科医院检验科,510095 [3]广州市胸科医院一门诊,510095 [4]广州市红十字会医院检验科,510220

出　　处：《实用医学杂志》2010年第23期4267-4269,共3页The Journal of Practical Medicine

基　　金：国家"十一五"重大传染病专项资助项目(编号:2009ZX10003-018);广州市医药卫生科技重大项目(编号:2009-ZDa-03)

摘　　要：目的:探讨直接检测痰液标本MPB64蛋白作为结核病快速诊断方法的可能性。方法:对65例肺结核病患者和72例非结核病患者的痰液标本同时进行痰涂片染色抗酸菌检查、实时荧光定量PCR检测结核杆菌DNA和免疫胶体金法检测MPB64蛋白,比较分析3种方法的检测结果,并依据临床诊断对MPB64蛋白检测结果进行诊断方法学评价。结果:MPB64蛋白检测法与涂片染色、荧光定量PCR检测结果的符合率均为60.58%;MPB64蛋白检测的敏感度、特异度、准确度分别为58.46%、69.44%和64.23%,其敏感度显著高于涂片染色法的27.69%与荧光定量PCR法的35.38%,但其特异度和准确度则低于涂片染色法(100%、65.69%)与荧光定量PCR法(98.61%、68.61%)。结论:采用免疫胶体金法直接检测痰液标本中MPB64蛋白对结核病的诊断具有较高的敏感度,可以作为筛查检测手段;但特异度相对较低,可否作为一种结核病快速诊断方法值得进一步研究。Objective To study the possibility of rapid diagnosis of tuberculosis by directly detecting MPB64 protein in sputum sample. Methods 137 sputum samples from 65 pulmonary tuberculosis patients and 72 patients without tuberculosis were tested simultaneously by three experimental methods including smear to find AFB,real-time fluorescence quantitative PCR to determine DNA of mycobacterium tuberculosis and immune colloidal gold method to detect MPB64 protein. The test results of the three methods were analyzed comparatively. And methodological evaluation of direct detection of MPB64 protein in sputum sample was carried out based on clinical diagnosis. Results The coincidence rates between MPB64 protein detection and sputum smear,real-time fluorescence quantitative PCR were both 60.58%. The sensitivity,specificity,and accuracy of the method by directly detecting MPB64 protein in sputum sample were 58.46%,69.44%,64.23% respectively,while those of smear staining were 27.69%,100%,65.69%,and those of fluorescence quantitative PCR were 35.38%,98.61%,68.61%. Conclusion The method,in which MPB64 protein is detected directly in sputum sample by immune colloidal gold reagent,has relatively high sensitivity and may serve as a screening tests of tuberculosis. But,the specificity is vice versa. It is essential that further study be performed for conformation of the value as a rapid diagnostic method.

关 键 词：结核 MPB64 方法学评价 

分 类 号：R52[医药卫生—内科学]