中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2011年
13期
7-10
,共4页
吴俐健%邹博%张含玉%孙美秋%贾本智%聂芳%王笑歌
吳俐健%鄒博%張含玉%孫美鞦%賈本智%聶芳%王笑歌
오리건%추박%장함옥%손미추%가본지%섭방%왕소가
分枝杆菌,结核%血清学%评价研究
分枝桿菌,結覈%血清學%評價研究
분지간균,결핵%혈청학%평개연구
Mycobacterium tuberculosis%Serology%Evaluation studies
目的 以重组结核分枝杆菌16 ku-38 ku-ESAT-6融合蛋白(以下简称重组蛋白)为包被抗原,探讨该抗原对结核病的诊断价值.方法 结核组105例、对照组45例(包括非结核病患者25例及健康体检者20例),以重组蛋白作为包被抗原,采用酶联免疫吸附试验(ELISA)检测150例受检者血清中的重组蛋白抗体水平,得出各组之间的吸光度值及阳性率,并与结核分枝杆菌抗体胶体金法诊断试剂盒的检测结果进行比较,以此来评价重组蛋白对结核病的诊断价值,并建立受试者工作特征(ROC)曲线评价系统.结果 重组蛋白检测对照组的阳性率为6.67%(3/45),与试剂盒检测阳性率[51.11%(23/45)]比较差异有统计学意义(P＜0.01),结核组阳性率为59.05%(62/105),与试剂盒检测阳性率[64.76%(68/105)]比较差异无统计学意义(P＞0.05).结核组与对照组的吸光度值分别为2.22±0.58、1.35±0.24,两组比较差异有统计学意义(t=6.06,P＜0.01);重组蛋白检测结核病的敏感度、特异度、阳性预测值及阴性预测值分别为59.05%、93.33%、95.38%、49.41%.应用ROC曲线分析,得出曲线下面积为0.751,cutoff值为2.52,此时敏感度及特异度分别为65.4%、84.8%.结论 重组蛋白检测血清结核抗体具有较高的特异度,可以更好地区分结核病患者群与非患者群,可以作为结核病诊断的备选抗原之一.
目的 以重組結覈分枝桿菌16 ku-38 ku-ESAT-6融閤蛋白(以下簡稱重組蛋白)為包被抗原,探討該抗原對結覈病的診斷價值.方法 結覈組105例、對照組45例(包括非結覈病患者25例及健康體檢者20例),以重組蛋白作為包被抗原,採用酶聯免疫吸附試驗(ELISA)檢測150例受檢者血清中的重組蛋白抗體水平,得齣各組之間的吸光度值及暘性率,併與結覈分枝桿菌抗體膠體金法診斷試劑盒的檢測結果進行比較,以此來評價重組蛋白對結覈病的診斷價值,併建立受試者工作特徵(ROC)麯線評價繫統.結果 重組蛋白檢測對照組的暘性率為6.67%(3/45),與試劑盒檢測暘性率[51.11%(23/45)]比較差異有統計學意義(P＜0.01),結覈組暘性率為59.05%(62/105),與試劑盒檢測暘性率[64.76%(68/105)]比較差異無統計學意義(P＞0.05).結覈組與對照組的吸光度值分彆為2.22±0.58、1.35±0.24,兩組比較差異有統計學意義(t=6.06,P＜0.01);重組蛋白檢測結覈病的敏感度、特異度、暘性預測值及陰性預測值分彆為59.05%、93.33%、95.38%、49.41%.應用ROC麯線分析,得齣麯線下麵積為0.751,cutoff值為2.52,此時敏感度及特異度分彆為65.4%、84.8%.結論 重組蛋白檢測血清結覈抗體具有較高的特異度,可以更好地區分結覈病患者群與非患者群,可以作為結覈病診斷的備選抗原之一.
목적 이중조결핵분지간균16 ku-38 ku-ESAT-6융합단백(이하간칭중조단백)위포피항원,탐토해항원대결핵병적진단개치.방법 결핵조105례、대조조45례(포괄비결핵병환자25례급건강체검자20례),이중조단백작위포피항원,채용매련면역흡부시험(ELISA)검측150례수검자혈청중적중조단백항체수평,득출각조지간적흡광도치급양성솔,병여결핵분지간균항체효체금법진단시제합적검측결과진행비교,이차래평개중조단백대결핵병적진단개치,병건립수시자공작특정(ROC)곡선평개계통.결과 중조단백검측대조조적양성솔위6.67%(3/45),여시제합검측양성솔[51.11%(23/45)]비교차이유통계학의의(P＜0.01),결핵조양성솔위59.05%(62/105),여시제합검측양성솔[64.76%(68/105)]비교차이무통계학의의(P＞0.05).결핵조여대조조적흡광도치분별위2.22±0.58、1.35±0.24,량조비교차이유통계학의의(t=6.06,P＜0.01);중조단백검측결핵병적민감도、특이도、양성예측치급음성예측치분별위59.05%、93.33%、95.38%、49.41%.응용ROC곡선분석,득출곡선하면적위0.751,cutoff치위2.52,차시민감도급특이도분별위65.4%、84.8%.결론 중조단백검측혈청결핵항체구유교고적특이도,가이경호지구분결핵병환자군여비환자군,가이작위결핵병진단적비선항원지일.
Objective To investigate the diagnostic value of 16 ku-38 ku-ESAT-6 protein in tuberculosis (TB). Methods ELISA was used for measuring the level of recombinant 16 ku-38 ku-ESAT-6 protein in 105 TB patients (TB group,26 patients with smear-positive, 79 patients with smear-negative) and 45 controls (control group, 20 healthy volunteers and 25 subjects with pulmonary diseases other than TB). The value of the antigen for diagnosis of TB in serodiagnosis was assessed, and ROC curve evaluation system was established. Results In control group, the positive rate of anti-recombinant 16 ku-38 ku-ESAT-6 protein and commercialization of TB antibody test kit had significant difference [6.67% (3/45) vs. 51.11% (23/45)](P＜0.01);but in TB group, there was no significant difference [59.05%(62/105) vs. 64.76% (68/105)](P＞0.05). The optical density value in TB group and control group was 2.22 ± 0.58 and 1.35 ± 0.24,and there was significant difference(t = 6.06,P＜ 0.01). The sensitivity, specificity, positive predictive value and negative predictive value of the test was 59.05%,93.33%,95.38%,49.41% respectively. Analyzed by ROC curve, the area under the curve was 0.751, the- value of cutoff was 2.52, and sensitivity and specificity was 65.4% and 84.8%. Conclusions Recombinant 16 ku -38 ku -ESAT-6 protein of mycobacterium tuberculosis has higher specificity, and it can significantly distinguish TB and non-TB. So it might be selected as one of diagnosis antigens of TB.
