结核分枝杆菌肝素结合血凝素对结核性胸膜炎诊断、鉴别诊断的临床观察  

Diagnosis and differential diagnosis of heparin-binding hemagglutinin adhesin in tuberculous pleurisy

作　　者：聂理会[1,2] 任卫聪[1,3] 王敬[1,2] 李传友[1,3] 

机构地区：[1]北京市结核病胸部肿瘤研究所 [2]首都医科大学附属北京胸科医院结核一科,北京101149 [3]首都医科大学附属北京胸科医院细菌免疫室,北京101149

出　　处：《中国临床医生杂志》2013年第3期27-28,共2页Chinese Journal For Clinicians

基　　金："十二五"重大新药创制科技重大专项课题;"抗结核药物新药临床评价研究技术平台建设"(2012ZX09303002)

摘　　要：目的探讨结核分枝杆菌肝素结合血凝素对结核性胸膜炎诊断、鉴别诊断的价值。方法选取结核性胸腔积液患者54例为观察组,另选取恶性肿瘤胸膜转移患者40例为对照组,以重组结核分枝杆菌肝素结合血凝素为抗原,通过酶联免疫吸附测定法(ELISA)检测患者胸腔积液中IgG抗体。结果观察组IgG抗体高于对照组,差异有显著性(P<0.05);ROC曲线分析结果显示,胸水中IgG抗体的诊断临界值为0.46时,诊断敏感度为90.7%、特异度为90.0%、准确度为90.4%。结论结核分枝杆菌肝素结合血凝素对结核性胸膜炎的辅助诊断,以及与恶性肿瘤胸膜转移的鉴别诊断具有重要价值。Objective To explore the value of HBHA protein from Myeobaeterium tuberculosis as antigen in the diag- nosis and differential diagnosis of tuberculous pleurisy. Method 54 cases with tuberculosis pleural effusion was en- rolled as observation group and 40 eases with malignant pleural effusion were enrolled as control group, recombinant HBHA protein from Myeobacterium tuberculosis was used as antigen, The level of IgG antibody in all of the speci- mens were analyzed by enzyme linked immune-absorbent assay（ELISA）. Result The level of antibody IgG was high- er in Observation group compared with control group, and the difference was significant （P〈0.05） , the diagnostic sensitivity, specificity and efficiency of was 90.7% , 90.0% and 90.4% respectively with a cut-off value of 0.46 estimated from receiver operating characteristic analysis Conclusion The recombinant HBHA protein has a good val- ue in diaznosis of tuberculous pleurisy and differential diaznosis to malignant pleural effusion.

关 键 词：结核分枝杆菌肝素结合血凝素 结核性胸膜炎 恶性肿瘤胸膜转移 鉴别诊断 

分 类 号：R521.7[医药卫生—内科学]