临床误诊误治
臨床誤診誤治
림상오진오치
CLINICAL MISDIAGNOSIS & MISTHERAPY
2014年
6期
47-49
,共3页
蛋白芯片%抗体%结核分枝杆菌%结核,肺%诊断
蛋白芯片%抗體%結覈分枝桿菌%結覈,肺%診斷
단백심편%항체%결핵분지간균%결핵,폐%진단
Protein chip%Antibody%Mycobacterium tuberculosis%Tuberculosis,pulmonary%Diagnosis
目的探讨结核抗体蛋白芯片法对老年肺结核的诊断价值。方法选择93例肺结核及77例肺部非特异性感染老年患者,均行痰涂片抗酸染色试验,均采用结核分枝杆菌IgG抗体检测试剂盒(蛋白芯片)检测抗结核分枝杆菌脂阿拉伯甘露醇( LAM)、基因工程重组的16 kD和38 kD的IgG抗体,计算两种方法诊断结核分枝杆菌感染的敏感性及特异性；并分别构建受试者工作特征曲线,通过比较曲线下面积( area under the curve, AUC)评价其诊断效能。结果蛋白芯片法和痰涂片抗酸染色试验诊断结核分枝杆菌感染的敏感性分别为68.82%和33.33%,特异性分别为100.00%和97.40%；AUC分别为0.84和0.65,提示蛋白芯片法的诊断效能显著高于痰涂片抗酸染色法,差异有统计学意义(P<0.01)。结论蛋白芯片法检测抗结核分枝杆菌LAM、16 kD和38 kD抗体快捷简便,对诊断老年肺结核有较高的实用价值。
目的探討結覈抗體蛋白芯片法對老年肺結覈的診斷價值。方法選擇93例肺結覈及77例肺部非特異性感染老年患者,均行痰塗片抗痠染色試驗,均採用結覈分枝桿菌IgG抗體檢測試劑盒(蛋白芯片)檢測抗結覈分枝桿菌脂阿拉伯甘露醇( LAM)、基因工程重組的16 kD和38 kD的IgG抗體,計算兩種方法診斷結覈分枝桿菌感染的敏感性及特異性；併分彆構建受試者工作特徵麯線,通過比較麯線下麵積( area under the curve, AUC)評價其診斷效能。結果蛋白芯片法和痰塗片抗痠染色試驗診斷結覈分枝桿菌感染的敏感性分彆為68.82%和33.33%,特異性分彆為100.00%和97.40%；AUC分彆為0.84和0.65,提示蛋白芯片法的診斷效能顯著高于痰塗片抗痠染色法,差異有統計學意義(P<0.01)。結論蛋白芯片法檢測抗結覈分枝桿菌LAM、16 kD和38 kD抗體快捷簡便,對診斷老年肺結覈有較高的實用價值。
목적탐토결핵항체단백심편법대노년폐결핵적진단개치。방법선택93례폐결핵급77례폐부비특이성감염노년환자,균행담도편항산염색시험,균채용결핵분지간균IgG항체검측시제합(단백심편)검측항결핵분지간균지아랍백감로순( LAM)、기인공정중조적16 kD화38 kD적IgG항체,계산량충방법진단결핵분지간균감염적민감성급특이성；병분별구건수시자공작특정곡선,통과비교곡선하면적( area under the curve, AUC)평개기진단효능。결과단백심편법화담도편항산염색시험진단결핵분지간균감염적민감성분별위68.82%화33.33%,특이성분별위100.00%화97.40%；AUC분별위0.84화0.65,제시단백심편법적진단효능현저고우담도편항산염색법,차이유통계학의의(P<0.01)。결론단백심편법검측항결핵분지간균LAM、16 kD화38 kD항체쾌첩간편,대진단노년폐결핵유교고적실용개치。
Objective To investigate the value of tuberculosis protein chip method in diagnosis of elderly patients with pulmonary tuberculosis. Methods A total of 93 elderly patients with pulmonary tuberculosis and 77 patients with nonspecific lung infection were recruited in this study, and the antibodies of mycobacterium tuberculosis ( MTB) lipoarabinomannan ( LAM) and genetic engineering custom-crafted 16 kD and 38 kD-IgG were detected by using diagnostic kit for IgG antibody to mycobac-terium tuberculosis and acid-fast staining test of sputum smear, The sensitivity and specificity of the two methods in diagnosis of mycobacterium tuberculosis infection were calculated respectively, and the receiver operating characteristic curves were built re-spectively, and then the diagnostic values were evaluated by comparing the areas under the curves ( AUC) . Results The sensi-tivity and specificity of tuberculosis protein chip method and acid-fast staining test of sputum smear in diagnosis of mycobacterium tuberculosis infection were 68. 82% &33. 33% and 100. 00% &97. 40% respectively;the AUC was 0. 84 and 0. 65 respective-ly, which showed that the diagnostic value of tuberculosis protein chip method was much better when compared with that of acid-fast staining test of sputum smear, and the differences were of statistical significance (P<0. 01). Conclusion The tuberculosis protein chip method in detection of LAM, 16 kD and 38 kD-IgG antibodies of mycobacterium tuberculosis is simple, quick and has significant practical value in diagnosis of elderly patients with pulmonary tuberculosis.
