检测脑脊液结核抗体对结核性脑膜炎的诊断价值

Determination of Mycobacterium Tuberculosis Specific Antibody in CSF in Diagnosis of Tuberculosis Meningitis

目的观察脑脊液中结核分枝杆菌特异性抗体检测对结核性脑膜炎(tuberculous meningitis,TBM)的诊断价值。方法按照TBM的临床诊断标准和排除标准,选择临床确诊TBM病例30例为研究对象,并选择35例非结核性中枢神经系统疾病作为对照组。收集每个病人在首次腰穿的脑脊液和当天的静脉血标本,用胶体金标记方法进行检测。结果实验组脑脊液检测的阳性率显著高于对照组(P<0.01),实验组血清的检测阳性率也显著高于对照组(P<0.01)。脑脊液的敏感度为83.33%,特异度为88.57%;血清的敏感度为70%,特异度为77.14%。脑脊液与血清的检测的阳性率比较无显著差异(P>0.05)。结论此种混合抗原是一种简便、快捷的诊断TBM的辅助方法。

Objective To evaluate the clinical meaning in determinating mycobacterium tuberculous specific antibody in CSF in diagnosis of tuberculosis meningitis （TBM）. Methods According to the diagnosis and excluding criteria of TBM, 30 patients with TBM and 35 age- mating patients with non- tuberculotic disease in central nervous system Were chosen as experimental group and control group respectively. Both CSF and blood of patients were collected and determined by immunogold labeling technique. Results The positive rates of CSF and serum n experimental group were all significantly higher than those of the controls （P〈0.01）. The sensitivity and the specificity of CSF were 83.33% and 88.57% respectively. The sen- sitivity and the specificity of serum were 70 % and 77.14 % respectively. No significant difference was found by the comparison of positive rates in CSF and serum. Conclusion The determination of specific antibody by this mixing antigen car be considered as a simple and fast auxiliary technique in diagnosis of TBM.