结核分枝杆菌三种蛋白在结核病血清学诊断中的评价研究  

The Evaluation Study of Three Mycobacterium tuberculosis Proteins in Tuberculosis Serologic Diagnosis

作　　者：刘毅[1] 张旭霞[1] 张雨晴[1] 李传友[1] Liu Yi;Zhang Xuxia;Zhang Yuqing;Li Chuanyou(Department Of Bacteriology and Immunology, Beijing Key Laboratory on Drug-Resistant Tuberculosis Research, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing Chest Hospital, Capital Medical University, Beijing 101149, China)

机构地区：[1]北京市结核病胸部肿瘤研究所首都医科大学附属北京胸科医院耐药结核病重点实验室细菌免疫室,101149

出　　处：《结核病与胸部肿瘤》2018年第1期1-6,共6页Tuberculosis and Thoracic Tumor

基　　金：首都卫生发展科研专项（2014-42163）;北京市医院管理局青苗计划（QML20161601）

摘　　要：目的对结核分枝杆菌相对分子质量为38000（以下采用38kD表示）、线粒体通透性转换蛋白64 （ mitochondrial permeabilitytransition 64, MPT-64 ）和肝素结合血凝素（ heparin-binding haemagglutinin, HBHA ）蛋白在外周血中抗体的表达水平进行检测和比较，并对它们在结核病血清学方面的诊断价值进行评估。方法选取2012年7月至2013年10月北京胸科医院收治的肺结核患者作为活动性肺结核（ATB）组，共78例；选取同期36例潜伏结核感染（LTBI）患者作为LTBI组；同期在北京胸科医院进行体检的31名健康人群（HC）作为HC组。将本实验室前期纯化的38kD、MPT64和HBHA作为抗原应用于免疫学的检测，采用酶联免疫吸附实验（ELISA）检测血清中三种蛋白抗体的表达水平，经过统计学处理后，分别比较ATB、LTBI和HC三组之间的差异，并结合受试者工作特征曲线计算各蛋白抗原的敏感度和特异度，评价三种蛋白血清抗体的临床诊断价值。结果ELISA检测ATB组38kD蛋白抗体的吸光度（A）450nm处的A值（0．343±0．120）高于LTBI组（0.221±0．102）和HC组（0．143±0．097），差异有统计学意义（t=3．07，P〈0．05）；MPT64抗体的A450值（0．234±0．102）高于LTBI组（0．198±0．087）和HC组（0．123±0．075），差异有统计学意义（t=-3．79，P〈0．05）；HBHA抗体的A450值（0．263±0．113）高于LTBI组（0．188±0．091）和HC组（0．148±0．078），差异有统计学意义（t=2．70，P〈0．05）.以38kD、MPT64和HBHA蛋白抗体表达水平从LTBI组鉴别ATB组时的受试者工作特征（ROC）曲线下面积（AUC）分别为0．78、0．61和0．62，敏感度分别为71．79％、62．82％和52．56％，特异度为72．22％、58．33％和69．44％；从HC组鉴别ATB组时的AUC分别为0．91、0．81和0．79，敏感度分别为87．17％、69．23％和7308％，特异度为80．65％、74．19％和74．19％；从HC组鉴Objective To compare the antibody expression of three recombination Mycobacterium tuberculosis （MTB） protein antigens （MTB relative molecular mass 38 000 short as 38 kD, MPT64 and HBHA） in the peripheral blood serum, and comprehensively assess their performances in serologic diagnosis of tuberculosis （TB）. Methods Seventy eight active tuberculosis （ATB） cases and 36 latent tuberculosis infection （LTBI） cases were selected from Beijing Chest Hospital as case groups, during July 2012 to October 2013. And 31 healthy control （HC） cases were recruited from the TB physical examination in Beijing Chest Hospital at the same period. We used these purified protein generated by our laboratory as antigens to measure the expression level of antibodies in serum by ELSIA, then compared the difference between ATB, LTBI and HC by statistical method. Sensitivity, specificity and diagnostic efficiency were calculated after getting the receiver operating characteristic （ROC） curve analysis with the results of Enzyme-linked immunosorbent assay （ELISA）. Furthermore, comprehensive diagnosis performance and application values of these proteins were evaluated. ResultsThe absorbance （A）450m value of 38 kD measured by ELISA was higher in ATB group （0.343±0.120） than those in LTBI group （0.221 ± 0.102） and HC group （0.143± 0. 097）. The difference showed statistically significance （t=-3.07, P〈0. 05）. The A value of MPT64 measured by ELISA was higher in ATB group （0.234 ± 0.102） than those in LTBI group （0.198 ±0.087） and HC group （0.123 ± 0.075）. The difference showed statistically significance （t =3.79, P〈 0.05）. The A value of HBHA measured by ELISA was higher in ATB group （0.263 ± 0.113） than those in LTBI group （0. 188 ± 0. 091） and HC group （0.148 ± 0.078）. The difference showed statistically significance （t=2.70, P〈0.05）. Areas under the curve （AUC） of 38 KD, MPT64 and HBHA antibodies which used to distinguish ATB and LTBI were 0.78,

关 键 词：分枝杆菌 结核 细菌蛋白质类 酶联免疫吸附测定 抗体 血清学试验 评价研究 

分 类 号：R575.2[医药卫生—消化系统]