脂阿拉伯甘露聚糖诊断结核性脑膜炎的评价

The clinical evaluation of lipoarabinomannan for diagnosis of tuberculous meningitis

目的评价分枝杆菌脂阿拉伯甘露聚糖(LAM)的诊断价值并给出受试者工作特征曲线(ROC)。方法应用斑点金免疫渗滤技术平行检测结核性脑膜炎(TBM)及非结核性神经精神系统疾病血清(Serum)和脑脊液(CSF)中抗LAM抗体。Serum稀释25倍,CSF分别按1、2、4、8、16、32倍稀释。进行抗LAM抗体检测。结果Serum敏感性(Sencitivity,Se)为96.9%,特异性(Specificity,Sp)58.3%。CSF在稀释倍数为12、4、、8、163、2时Se分别为93.6%,90.6%,56.3%,37.5%,12.5%,3.1%,Sp分别为83.3%、95.8%、95.8%、100%、100%、100%。最佳截切值(Cut-Off)为2倍稀释。统计分析表明,CSF在2倍稀释时其Se与Serum无显著性差异,但Sp有显著性差异。结论应用斑点金免疫渗滤技术检测抗LAM抗体诊断价值较高。

meningitis and Objective To evaluate the clinical value of lipoarabinomannan for diagnosis of tuberculous to determine the ROC. Method The detection of anti-LAM-antibodies made by dot - immunolgold filtration assay in sera and cerebrospinal fuid （CSF） from patients with tuberculous meningitis and non- tuberculosis. The sera was diluted by 25 times and the CSF by 1,2,4,8,16,32 times. Results The sensitivity and specificity in serum was 96.9 % and 58.3 % respectively. The two indexes in CSF with the dilution of 1,2, 4,8, 16,32 times were 93.8%,90.6%,56.3%,37.5%,12.5%,3.1% and 83.3%, 95.8%, 95.8%, 100%, 100%, 100%. The best cut - off value was in CSF with dilution 2 times on which the specificity was significant difference compared with that of sera , but there was no significant different on sensitivity. Conclusion The detection of anti - LAM - antibodies in CSF made by dot - immunolgold assay is a useful tool.