结核分枝杆菌特异性重组抗原在结核病血清学诊断中的研究  

Studies on MTB specific recombination antigen in TB serology diagnosis

作　　者：程国平[1] 李克生[2] 

机构地区：[1]河南科技大学第一附属医院检验科,洛阳471000 [2]甘肃省医学科学研究院生物技术中心

出　　处：《中国实用医刊》2013年第9期58-60,共3页Chinese Journal of Practical Medicine

摘　　要：目的从检验医学的角度寻找新的规范性结核病检测方法，试图提高结核病临床实验室诊断水平。方法用已建立的Mtb8．4蛋白、38KD蛋白、MPT64蛋白和MPT63蛋白四种结核分枝杆菌特异性抗原重组蛋白酶联免疫吸附试验（ELISA）检测系统检测102例阳性和98例阴性临床标本，以ROC曲线确定四种抗原蛋白ELISA检测的“阳性判断”值（cut-off值）。用市售的结核抗体检测试剂盒检测同一批标本。整理甘肃省肺科医院抗酸染色结果病例资料。结果四种特异性抗原联合检测临床标本的灵敏度为82．4％，特异性为88．7％。痰涂片组和结核抗体组检测标本的灵敏度分别是42．2％和51．9％，结核抗体组特异性是81．8％。用SPSS11．5软件分析结果，痰涂片组和结核抗体组分别与特异性抗原联合组对比，差异均有统计学意义（P〈0．05）。结论特异性抗原联合检测结核病患者血清的灵敏度和特异性优于目前临床推广使用的结核抗体检测法，灵敏度优于经典的抗酸染色法。Objective To eleuate the diagnostic level of tuberculosis in the clinical laboratory with the methods of four species antigen combination. Methods A standard detection system of mycobacterium tuberculosis（MTB） specific antigen-recombinated MtbS. 4, 38KD, MPT64 and MPT63 protein by enzyme-linked immunosorbent assay （ELISA） was setted up. Using the standard ELISA system that had been set up to detect the clinical samples collected. Receiver operating characteristic method was used to determine the cut-off. At the same time, the clinical samples were detected by acid-fast staining and MTB antibody method. The sensibility and the specificity among the methods were compared. Results The sensibility of acid-fast staining, MTB antibody method and four species antigen combination method were 42. 2% , 51.9% and 82.4% respectively, and the specificity of MTB antibody method and four species antigen combination method were 81.8% and 88.3% respectively. Conclusions Association MTB specific antigen-recombinated Mtb8.4, 38KD, MPT64 and MPT63 proteins make the sensibility and the specificity higher in TB serology diagnosis.

关 键 词：重组蛋白 ROC曲线 CUT-OFF值 结核分枝杆菌 结核病 

分 类 号：R446.6[医药卫生—诊断学] R52[医药卫生—临床医学]