重组结核分枝杆菌38KDa蛋白用于军人结核分枝杆菌感染筛查  

Recombinant 38 Kilo-Dalton Protein of Mycobacterium Tuberculosis Diagnoses Latent Mycobacterium Tuberculosis Infection in Soldiers

作　　者：何秀云[1] 庄玉辉[1] 

机构地区：[1]中国人民解放军第309医院中心实验室,北京100091

出　　处：《现代检验医学杂志》2012年第3期16-18,共3页Journal of Modern Laboratory Medicine

基　　金：基金项目：国家‘863,计划资助项目（2004AA0223712）.

摘　　要：目的评价重组结核分枝杆菌蛋白38KDa皮试注射液（rTPA38）用于军人结核分枝杆菌感染筛查的价值。方法以结核菌素纯蛋白衍生物（PPD）为对照，采用同体双臂Mantoux法（皮内注射）为1150人同时做PPD和rTPA38皮试；皮试后24h，48h双盲测量皮试反应（包括红晕或硬结）。PPD和rTPA38皮试阴性者接种卡介苗，3个月后同前进行皮试试验。结果局部皮肤红晕（或硬结）横、纵平均直径≥5mm为阳性。24．6％受试者rTPA38皮试反应阳性，阳性反应直径集中于5mm～10mm；53．0％受试者PPD皮试反应阳性，阳性反应直径集中于5mm～15mm。rTPA38皮试反应阳性率随年龄增长基本呈现上升趋势，同一年龄段，rTPA38皮试反应阳性率明显低于PPD（P〈0．01）。有卡痕与无卡痕受试者rTPA38皮试反应阳性率比较、统计学分析差异有极显著性意义（χ^2=27．06，P〈0．01）。PPD皮试阳转率与rT—PA38皮试阳转率分别为62．0％和27．2％，两者比较差异有极显著性意义（χ^2=52．90，P〈0．01）。结论rTPA38可作为结核分枝杆菌感染筛查的诊断试剂。Objective In order to evaluate the potential of recombinant truncated 38 kilodalton protein of Mycobacterium tuberculosis （rTPA38） as tuberculosis-specific tuberculin. Methods 1 150 healthy controls were recruited to assess rTPA38 and 221 healthy controls, with negative responses to rTPA38 and PPD, were vaccinated with M. boy＇s BCG to determine cross-reactions between rTPA38 and M. bowls BCG. The skin test was performed according to the Mantoux technique in the volar aspect of different forearms,and independent blinded investigators were chosen for measuring induration or erythema. Results The positive skin reactions were defined as induration or erythema greater than or equal to 5 mm. The positive rate of 1150 tested people was 53.0 % and 24.5 % for PPD and rTPA38,respectively. The positive diameter induced by rTPA38 ranged from 5 mm to 10 mm,and the diameter by PPD ranged from 5 mm to 15 ram. There were parallel responses in the positive rate between PPD and rTPA38. The positive reactions to rTPA38 changed with ages. The difference in the positive rate of each age group between rTPA38 and PPD was statistically significant （P〈0.01）. For rTPA38 there was a dramatic difference in the positive rate between tested people with BCG scar and without BCG scar （χ^2 = 27.06, P〈0.01）. For the tested people vaccinated with M. boris BCG, the positive responses to rTPA38 were lower than to PPD （62.0 % vs 27.2 % ; χ^2=52.90, P〈0.01）. Conclusion These findings show that rTPA38 appears to become tuberculosis-specific skin test anti- gen for diagnosing tuberculosis and screening Mycobacteriurn tuberculosis infection.

关 键 词：结核分枝杆菌 皮试 38KDa蛋白 

分 类 号：R378.911[医药卫生—病原生物学] R446.62[医药卫生—基础医学]