结核蛋白芯片在肺结核诊断中的应用价值  

The application value of protein biochip in the diagnosis of pulmonary tuberculosis

作　　者：竺澎波[1] 陈虹[1] 高鸣[1] 

机构地区：[1]广州市胸科医院,510095

出　　处：《实用医学杂志》2012年第15期2593-2595,共3页The Journal of Practical Medicine

摘　　要：目的:通过蛋白芯片检测系统检测结核蛋白抗体,探讨血清学抗体联合检测在肺结核诊断中的应用价值。方法:收集本院2011年3-5月采用蛋白芯片检测系统检测CFP10、LAM、ESAT-6、38KD、16KD抗体的患者资料,对52例临床诊断为肺结核患者(菌阳20例、菌阴32例)、33非结核患者资料进行回顾性分析,评价蛋白芯片在肺结核诊断中的应用价值。蛋白芯片检测结果判断标准:5种抗体任一阳性结果判为阳性,5种抗体全阴结果判为阴性。结果:(1)肺结核菌阳组、菌阴组CFP10、LAM、ESAT-6、38KD、16KD五项抗体阳性检出率分别为10%、60.0%、10%、10%、20%;9.3%、46.9%、9.3%、15.6%、9.3%。(2)肺结核组、非结核组五项抗体联合检测阳性率分别为71.2%、15.1%,差异有统计学意义(χ2=22.5,P=0.00);肺结核菌阳组、菌阴组抗体联合检测阳性率分别为85.0%、62.5%,差异无统计学意义(χ2=3.03,P=0.081),与同组LAM抗体(五抗体中检出率最高者)检出率相比较,通过抗体联合检测,菌阳组检出率提高25.0%,菌阴组提高15.6%。(3)五项抗体联合检测肺结核的特异性为84.8%,敏感性为71.2%,准确率为74.3%,阳性预测值为87.5%,阴性预测值为62.2%,阳性似然比为4.6,阴性似然比为0.339。结论:应用蛋白芯片联合检测血清学抗体试验是辅助诊断肺结核的较好方法,具快速、便捷、高敏感性、高准确率及阳性预测值等优势,具有较高的临床应用价值。Objective To evaluate the application value of the joint detection of serological antibodies in the diagnosis of pulmonary tuberculosis through protein biochip detective system. Methods From March to May 2011, a retrospective analysis of tuberculosis serological antibodies was carried out in 52 patients with pulmonary tuberculosis and 33 patients without tuberculosis. The judgment standard of protein biochip as follow： one of the 5 antibodies （CFP10, LAM, ESAT-6, 38 KD and 16KD） was positive was considered positive; all of the 5 antibodies were negative was considered negative. Results The positive rates of CFP-10, LAM, ESAT-6, 38 KD and 16KD in sputum positive or negative pulmonary tuberculosis groups were 10%, 60.0%, 10%, 10%, 20% and 9.3%, 46.9%, 9.3%, 15.6%, 9.3%, respectively. The combined positive rates of the 5 tuberculosis antibodies in tuberculosis and non-tuberculosis groups were 71.2% and 15.1%, respectively （X2 = 22.5, P = 0.00）. In tuberculosis group, the positive rates of the 5 tuberculosis antibodies in sputum positive and negative patients were 85.0% and 62.5%, respectively （X2 = 3.03, P = 0.081）. As compared with the positive rate of LAM which gained the highest positive rate in the same group, the combined positive rate was improved by 25% in sputum positive group, and by 15.6% in sputum negative group. The specificity, sensitivity, accuracy, positive predictive value, negative predictive value, positive likelihood ratio, and negative likelihood ratio of the 5 antibodies in tuberculosis group were 84.8%, 71.2%, 74.3%, 87.5%, 62.2%, 4.6, and 0.339, respectively. Conclusion Detecting serological antibodies by protein biochip is a quick and convenient method with high sensitivity, accuracy and positive predictive value in assistant diagnosis of pulmonary tuberculosis.

关 键 词：分枝杆菌 结核 结核抗体 联合检测 血清学诊断 

分 类 号：R521[医药卫生—内科学]