脑脊液单核细胞内ESAT-6对结核性脑膜炎的诊断价值  

The value of ESAT-6 in the monocytes of CSF in diagnosis of tuberculous meningitis

作　　者：杨笑[1] 郭旻[2] 谢鹏[1] 

机构地区：[1]重庆医科大学附属第一医院,重庆医科大学神经科学研究中心,重庆400016 [2]宁夏医科大学第二附属医院

出　　处：《中国神经精神疾病杂志》2012年第6期330-333,共4页Chinese Journal of Nervous and Mental Diseases

基　　金：宁夏自然科学基金项目(编号:NZ10150)

摘　　要：目的通过检测结核性脑膜炎(tuberculous meningitis,TBM)患者脑脊液单核细胞中的早期分泌抗原靶蛋白6(early secreted antigenic target,ESAT-6),探讨ESAT-6在TBM诊断中的价值。方法将42例TBM患者与47例对照组患者进行脑脊液生化、细胞学、抗酸染色检查,同时用免疫荧光细胞化学染色法检测脑脊液单核细胞内的ESAT-6。结果在临床诊断TBM的42例患者中有38例脑脊液单核细胞中检出ESAT-6,47例对照组中检出4例。TBM组ESAT-6的检出率明显高于对照组(P<0.05)。该方法诊断TBM的敏感性为90.48%,特异性为91.49%。约登指数达到0.82。结论检测脑脊液单核细胞内结核特异性抗原ESAT-6用于诊断TBM,具有灵敏度、特异度高的特点,而且简单易行,有望成为诊断TBM的一种新的辅助方法。Objective Evaluate the value of ESAT-6 in diagnosis of tubercular meningitis by detecting ESAT- 6 in the monocytes of CSF. Methods 42 patients with tuberculous meningitis were chosen as TBM group and 47 patients with non-tuberculous intracranial infections as control group. All patients in both groups had routine biochemical test, cytology examination （May-Grunwald Giemsa stain） and acid fast stain tests, while immunofluorescence eytoehemieal staining was used to detect ESAT-6 in the monocytes of CSF. Results In TBM group, 38 patients showed positive ESAT-6 in the monoeytes of CSF, while only 4 showed positive ESAT-6 in the control group. The positive rate of ESAT-6 in TBM group was significantly higher than that in the control group （P 〈 0.05 ）, its sensitivity was 90.48%, and specificity was 91.49%. Youden index is 0.82. Conclusions The ESAT-6 detection, with high sensitivity and specificity, is a simple and feasible method in diagnosis of tuberculous meningitis.

关 键 词：结核性脑膜炎 脑脊液 早期分泌抗原靶蛋白6 

分 类 号：R529.3[医药卫生—内科学]