血清结核抗体检测在结核病临床诊断中的价值  

The value of tuberculosis antibody in the diagnosis of tuberculosis

作　　者：孟苏凯[1] 吴振萍[1] 张玉华[1] 钟达[1] 

机构地区：[1]天津市结核病控制中心,天津300041

出　　处：《中国卫生检验杂志》2015年第22期3858-3860,共3页Chinese Journal of Health Laboratory Technology

摘　　要：目的综合评估肺结核患者血清结核抗体在结核病诊断及筛查中的应用价值。方法将371例实验对象分为3组:活动性肺结核组(189例)、实验对照组(122例)、健康成人对照组(60例),并分别进行痰涂片检查、结核分枝杆菌培养、结核菌素试验(PPD)和血清结核抗体检测。结果细菌学方法检测活动性肺结核的敏感性为49.7%(94/189),TB-Ab-Ig G检测活动性肺结核的总体敏感性为56.6%(107/189),TB-Ab-Ig G与细菌学方法敏感性相比差异无统计学意义(χ2=1.796,P>0.05);联合TB-SA抗体检测后,血清结核抗体敏感性为83.1%(157/189),与细菌学方法敏感性相比较,差异有统计学意义(χ2=47.06,P<0.01)。结论血清结核抗体联合检测具有很高的灵敏性,且操作简便,但由于存在一定的假阳性和假阴性,确诊时应综合考虑其他临床因素和相关辅助检查,其临床应用和诊断价值有待进一步提高。Objective To evaluate the clinical value of serum tuberculosis antibody test in the diagnosis and screening of tuber- culosis. Methods 371 cases of the subjects were divided into three groups, active pulmonary tuberculosis （189）, experimen- talcontrol group（122） and healthy control group （60）. They were respectively detected by Mycobacterium tuberculosis smear, culture, PPD skin test and tuberculosis antibody. Results The sensitivity of bacteria method was 49.7% （94/189）, the overall sensitivity of TB - Ab - IgG in the diagnosis of active pulmonary tuberculosis was 56.6% （ 107/189）, and there was no statisti- cal significance on the sensitivity difference between bacteria method and TB - Ab - IgG（χ2 = 1. 796, P 〉0.05）. After the joint detection, the sensitivity of tuberculosis antibody was 83.1% （ 157/189）, and compared with the sensitivity with bacterial meth- od, there was statistical significance on the difference between them（χ2 = 47.06, P 〈 0.01 ）. Conclusion The joint detection of the serum TB - Ab - lgG is easy to perform with a high sensitivity. But with the emergence of false positives and false negatives, we should consider clinical manifestation and auxiliary examination. The clinical application and diagnostic value of the detec- tion should be improved.

关 键 词：结核分枝杆菌 抗体 诊断 

分 类 号：R446.5[医药卫生—诊断学]