三种结核抗体快速诊断试剂盒对三种常见结核病的诊断价值

Value of three kinds of tuberculosis antibodies in diagnosis of three common tuberculous diseases

目的 探讨三种结核抗体诊断试剂盒对肺结核、结核性脑膜炎 (结脑 )、结核性胸膜炎 (胸膜炎 )诊断价值。方法 采用澳大利亚产ICT -TB卡、TB -DOT和国产快速ELISA试剂盒检测 2 2 0例肺结核病人血清、56例结脑病人脑液、36例胸膜炎病人胸液与 4 8例非结核肺疾病血清、17例非结脑脑病脑液、18例非结核性胸膜炎胸液、30例健康人血清的结核抗体对比观察。结果 三种体液结核抗体总敏感性ICT -TB卡为 50 .7%、TB -DOT 52 .7%、ELSIA 58.7% ,三者间无显著性差异 (P >0 .0 5) ,其特异性分别为 97.3%、93.2 %、79.7% ,无显著性差异 (P >0 .0 5) ,ICT -TB卡对肺结核、结脑、胸膜炎血清结核抗体敏感性依次为 57.2 %、4 6 .4 %、30 .6 % ,TB -DOT 6 0 .0 %、4 4 .6 %、33.3% ,ELSIA6 8.2 %、4 2 .9%、38.9% ,有显著性差异 (P <0 .0 0 5,P <0 .0 5)。三种试剂盒检测三种体液结核抗体比较 ,血清敏感性最高 (57.2 %～ 6 8.2 % )、脑液次之 (51.8%～ 55.4 % ) ,胸液最低 (31.6 %～ 50 .0 % )。结论 抗原纯度较高的TB -DOT和ICT -TB卡特异性较强 ,但敏感性较低 ,复合抗原ELISA敏感性稍高 ,特异性偏低 ,但三者的临床价值基本相同。检测结核抗体对肺结核诊断价值优于结脑和胸膜炎。

Objective To study the value of three kinds of tuberculous antibodies in diagnosis of pulmonary tuberculosis,tuberculous meningitis and tuberculous pleurisy. Methods Select ICT-TB card,TB-DOT produced by Austrilia and homemade ELISA to detect tuberculous antibodies of 220 patients with pulmlonary tuberculosis,56 tuberculous miningitis,36 tuberculous pleurisy had been observed comparatively with 48 cases of non-tuberculosis lung diesase(serum),17 cases of non-tuberculosis meningitis brain disease(CSF),18 patients with pleurisy except tuberculosis(pleurorrhea),30 healthy individuals(serum). Results The sensitivity was 50.7%,52.7%,58.7%,there was no significant difference (P>0.05) in results detected by three kinds. The specificity was 97.3%,93.2%,79.7%,there was no singnificant difference (P>0.05). The sensitivity of ICT-TB card in serum of pulmonary tuberculosis,tuberculous meningitis and tuberculous pleurisy was 57.2%, 46.4%,30.6%,TB-DOT was 60.0%,44.6%,33.3%,ELISA was 68.2%,42.9%,38.9%. There was significant difference (P<0.005,P<0.05). To compare the sensitivity of three kinds to detect three kinds of body fluid with each other,the serum was highest (57.2%～68.2%), CSF was second(51.8%～55.4%),the pleurorrhea was third (31.6%～50.0%). Conclusion The specificity of ICT-TB card and TB-DOT is higher but the sensitivity is lower. On the contrary,the sensitivity of ELISA is higher and the specificity is lower. But in fact,the value in clinical is similar. To detect tuberculous antibodies in diagnosis of pulmonary tuberculosis is more valuable than in tuberculous meningitis and tuberculous pleurisy.