活动性结核标志物'H-多肽的实验与临床研究

EXPERIMENTAL AND CLINICAL STUDIES ON ACTIVE TUBERCULOSIS MARK

本题研究是经免疫学途径直接检测人体感染结核菌的情况，为现代结核病的实验诊断、临床监测、流行病调查提供了一个全新的检验指标。作者首先发现了一种仅存在于活动性结核病患者体液中的蛋白成份—活动性结核标志物（ＡｃｔｉｖｅＴｕｂｅｒｃｕｌｏｓｉｓＭａｒｋ—ＡＴＭ）１Ｈ—多肽；并为之创立了独特的检测方法，经四年多临床１９４６０例样本调查中确定了ＡＴＭ的临床价值。将ＡＴＭ检测与ＯＴ皮试、酶联免疫ＥＬＩＳＡ、ＤＮＡ探针、ＰＣＲ基因扩增技术及典型病例组患者行Ｘ线计算机断层摄影（ＣＴ）、磁共振像（ＭＲＩ）等多组对比试验中，实验与临床研究资料分析证明：ＡＴＭ检测的总敏感度为８６．０６％、特异度９６．２４％、准确度９３．４５％、诊断效率为８２．８２％、批内ＣＶ１．２％、批间ＣＶ２．０％、Ｐ＜０．０５。经ＮＭＲ光谱分析结构含有ＣＣＨ２官能团。

This item of studies offered an entire new test index for modem experimental diagnosis,clinial supervision and epidemic investigation of tuberculosis by immunological way to assay the conditions of patients being infected by tubercle bacillusThe main contents of this item were 1)a protein named by us active tuberculosis mark(ATM) was discoverec the first time in national and abroad,which existed only in body fluid of the patients with active tuberculosis;2)an unique method to assay ATM was established;3)the clinical values of assaying ATM were affirmed by investigation of 19460 cases of various diseases,for more than 4 yearsIt has significance for the tactics of elevating diagnostic and therapeutic levels and controlling tuberculosis put forwar by our contry goverment and other concerned departmentsit was ascertained that,assaying ATM to diagnose tuberculosis(pulmonary or at other organs or systems),the total sensitivity was 8606%,the specificity was 9624%,the accuracy was 9345% and the diagnostic efficiency was 8282%;the coefficients of variability inner or interbatches were 12% and 20%Comparison studies of ATM assay with other tuberculosis diagnosis techniques—OT or PPD intradermal test,ELISA to assay tuberculosis antibody,DNAprobe and PCR gene expansion technique to assay Tbacillus DNA,CT and MRI tissue imagery assayswere demonstrated,all-sidely analysed and evaluated;and the results showed that,in tuberculosis diagnosis,ATM assay was clinically more valuable than other techniques in use and when assayed together with imagery techniques(CT of MRI),ATM assay would cooperate with the imagery techniques in differential diagnosing tuberculosis and tumorATM assay could be used to supervise the effects of treatment to tuberculosis as wellThe discovery and assay of ATM have academic importence and clinical applicability in early finding,diagnosis and differentiation,evaluating therapeutic effects and prognosis of tuberculosis;and there is no similar report in home land or abroad based on technical tata consultation