结核分枝杆菌Rv2991、Rv3428c重组蛋白对菌阴肺结核的辅助诊断价值  

VALUE OF RECOMBINANT PROTEINS Rv2991 AND Rv3428C OF MYCOBACTERIUM TUBERCULOSIS IN ASSISTING THE DIAGNOSIS OF SMEAR-NEGATIVE PULMONARY TUBERCULOSIS

作　　者：胡建平[1] 韩俊垒[1] 边红芝[1] HU Jianping;HAN Junlei;BIAN Hongzhi(Department of Respiratory Medicine, Henan Chest Hospital, Zhengzhou 450002, China)

机构地区：[1]河南省胸科医院呼吸内科,河南郑州450002

出　　处：《精准医学杂志》2020年第6期481-484,489,共5页Journal of Precision Medicine

基　　金：河南省医学科技攻关计划项目(201602303)。

摘　　要：目的探讨结核分枝杆菌Rv2991、Rv3428c重组蛋白对菌阴肺结核的辅助诊断价值。方法选择2016年3月—2018年5月我院收治的初治菌阴肺结核患者100例(A组)及同期在我院接受治疗的其他肺部疾病患者100例(B组),在我院进行常规全身体检健康者100例(C组)作为对照,采集3组受试者的血液标本,分离出血清,采用酶联免疫吸附测定法检测并比较3组受试者血清结核分枝杆菌Rv2991、Rv3428c重组蛋白表达水平,绘制受试者工作特征(ROC)曲线,计算各重组蛋白检测的曲线下面积。结果A组患者血清结核分枝杆菌Rv2991、Rv3428c重组蛋白表达水平高于B组和C组(F=649.451、2156.945,q=43.381~81.529,P<0.05);而B组与C组比较差异无统计学意义(P>0.05)。将B组作为对照,绘制ROC曲线,血清结核分枝杆菌Rv2991、Rv3482c重组蛋白辅助诊断菌阴肺结核的曲线下面积分别为0.834(95%CI=0.778~0.895)以及0.829(95%CI=0.771~0.884),cut-off值分别为58000.50和48500.50,在该cut-off值下,血清结核分枝杆菌Rv2991、Rv3482c重组蛋白辅助诊断菌阴肺结核的灵敏度分别为92.3%、81.5%,特异度分别为85.5%、82.0%。结论血清结核分枝杆菌Rv2991、Rv3428c重组蛋白用于菌阴肺结核的辅助诊断特异度与灵敏度较高,具有一定的临床应用价值。Objective\To investigate the value of recombinant proteins Rv2991 and Rv3428c of Mycobacterium tuberculosis in assisting the diagnosis of smear-negative pulmonary tuberculosis.\Methods\A total of 100 previously untreated patients with smear-negative pulmonary tuberculosis who were admitted to our hospital from March 2016 to May 2018 were enrolled as group A;100 patients with other lung diseases who were treated in our hospital during the same period of time were enrolled as group B;100 individuals who underwent routine physical examination in our hospital during the same period of time were enrolled as healthy controls(group C).Blood samples were collected from all the three groups,and serum was separated to measure the expression levels of recombinant proteins Rv2991 and Rv3428c of Mycobacterium tuberculosis by ELISA.The receiver operating cha-racteristic(ROC)curve was plotted to measure the area under the ROC curve(AUC)of each recombinant protein.\ResultsGroup A had significantly higher expression levels of recombinant proteins Rv2991 and Rv3428c in serum than groups B and C(F=649.451,2156.945,q=43.381-81.529,P<0.05),and there were no significant differences between groups B and C(P>0.05).The ROC curve was plotted with group B as control,and serum recombinant proteins Rv2991 and Rv3482c of Mycobacte-rium tuberculosis had AUCs of 0.834(95%CI=0.778-0.895)and 0.829(95%CI=0.771-0.884),respectively,in assisting the diagnosis of culture-negative pulmonary tuberculosis at the cut-off values of 58000.50 and 48500.50,respectively,with sensitivities of 92.3%and 81.5%,respectively,and specificities of 85.5%and 82.0%,respectively.\Conclusion\Serum recombinant proteins Rv2991 and Rv3428c of Mycobacterium tuberculosis have high specificity and sensitivity in assisting the diagnosis of smear-negative pulmonary tuberculosis and thus hold promise for clinical application.

关 键 词：结核 肺 结核分枝杆菌 细菌蛋白质类 重组蛋白质类 ROC曲线 诊断 

分 类 号：R521[医药卫生—内科学] R521.9[医药卫生—临床医学]