两种人工合成抗原在麻风血清学诊断中的再评价  

Re-evaluation and Application of Two Synthetic Antigens in the Diagnosis of Leprosy

作　　者：靳亚莉[1] 薛光[1] 周晓维[1] 刘晓虹[1] 张振国[1] 吕成志[1] 宋顺鹏[1] 

机构地区：[1]大连市皮肤病医院,辽宁大连116000

出　　处：《中国皮肤性病学杂志》2017年第3期277-280,共4页The Chinese Journal of Dermatovenereology

摘　　要：目的评价两种人工抗原ND-O-BSA(ND)和NT-P-BSA(NT)在麻风血清学诊断中的价值。方法分别用ND-ELISA和NT-ELISA检测麻风患者、正常人及其他个体血清中的IgM和IgG,绘制ROC曲线(receiver operating characteristic curve)并计算诊断麻风的最佳临界值。用散点图显示OD值与细菌指数(BI)之间的关系。用ND-IgM-ELISA和NT-IgM-ELISA连续2年监测50名已治愈麻风患者血清中的抗体水平。结果 ND-IgM-ELISA,NT-IgM-ELISA,ND-IgG-ELISA和NT-IgG-ELISA 4组实验的ROC曲线下面积分别为0.98,0.95,0.88和0.82;cutoff值分别为0.14,0.20,0.19和0.24;敏感性分别为96.20%,85.00%,82.80%和80.00%;特异性分别为97.50%,95.00%,83.75%和76.25%。OD值与BI呈正相关。50名已治愈患者连续2年的监测中发现有6名血清抗体水平高于临界值。结论 NDIgM-ELISA实验的敏感性和特异性是最好的,且不存在交叉反应,其灵敏度高于查菌方法,可以早期检测到麻风抗体。其他三种方法仍可用于麻风血清抗体水平的监测。Objective To evaluate the value ofND-O-BSA（ND）and NT-P-BSA（NT）in the diagnosis of leprosy.Methods ND-ELISA and NT-ELISA were used to detect the antibodies IgM and IgG in the serum from the subjects mentioned above.The cutoff value of the diagnosis of leprosy was determined by ROC curve.And the relationship between the serological activity and bacterial index was displayed by plotting method.Results According to ROC, their AUC were 0.98,0.95,0.88 and 0.82,and the cutoff values were 0.14, 0.20,0.19 and 0.24 for the tests ND-IgM-ELISA,NT-IgM-ELISA,ND-IgG-ELISA and NT-IgG-ELISA respectively.The sensitivity were 96.20%,85.00%,82.80% and 80.00% and specificity were 97.50%,95.00%,83.75% and 76.25% for each test. The mean OD value of leprosy serum was positively correlated with the bacterial index. There were 6 out of 50 cured leprosy patients whose antibodies increased for two consecutive years.Conclusion The sensitivity and specificity of ND-IgM-ELISA are the best,whoes sensitivity is higher than BI for it can detect the antibodies against leprosy more earlier.The other three methods also can be used for detecting the antibodies against leprosy.

关 键 词：麻风 ND-0-BSA NT-P-BSA 酶联免疫吸附试验 

分 类 号：R755[医药卫生—皮肤病学与性病学]