免疫胶体金法检测支气管肺泡灌洗液MPB64对肺结核的诊断价值

DIAGNOSTIC VALUE OF BRONCHOALVEOLAR LAVAGE FLUID MPB64 IN IDENTIFYING PULMONARY TUBERCULOSIS WITH COLLOIDAL GOLD IMMUNIZATION

目的探讨免疫胶体金法检测支气管肺泡灌洗液(BALF)结核杆菌特异性分泌抗原MPB64在肺结核诊断中的应用价值。方法对113例肺结核患者和80例非结核患者的BALF进行免疫胶体金法检测MPB64、荧光定量PCR法检测结核分枝杆菌DNA及改良酸性罗氏培养基法结核分枝杆菌培养,比较分析3种方法的检测结果。结果 MPB64免疫胶体金法与荧光定量PCR法、改良酸性罗氏培养基法的符合率分别为58.03%和57.51%;以临床诊断结果为参照,免疫胶体金法检测MPB64的敏感度、特异度与准确度分别为61.95%、87.50%、72.54%。以荧光定量PCR法为参照,免疫胶体金法检测MPB64的敏感度、特异度与准确度分别为49.30%、63.11%、58.03%;以改良酸性罗氏培养基法为参照,免疫胶体金法检测MPB64的敏感度、特异度与准确度分别为48.21%、61.31%、57.51%。结论免疫胶体金法检测MPB64应用于支气管肺泡灌洗液对肺结核的临床诊断有辅助诊断价值,但检测的假阳性、假阴性值得进一步分析研究。

Objective To research the application value of identifying the mycobacterium tuberculosis complex by immunochromatographic assay using anti - MPB64 monoclonal antibodies （ MPB64 - ICA） in bronchoalveolar lavage fluid（BALF）. Methods Bronchoalveolar lavage fluid of 113 pulmonary tuberculosis patients and 80 non -tuberculosis patients were selected, and was carfled on the MPB64 - ICA, real time quantitative polymerase chain reaction （ RT - PCR）, and isolated cultured in lowenstein -jensen medium. The comparative analysis of three methods was conducted. Results The coincidence rate between MPB64 - ICA and RT - PCR was 58.03% ,the coincidence rate between MPB64 - ICA and isolated cultrue in L - J was 57.51%. Refer to the clinical diagnosis, the sensitivity, specificity and accuracy of MPB64 -ICA were 61.95% ,87.50% and 72.54% respectively; refer to RT - PCR, they were 49.30% ,63.11% and 58.03% ; and refer to isolated culture, they were 48.21% ,61.31% and 57.51% respectively. Conclusion As an auxiliary diagnosis method, it maybe has significance in diagnose pulmonary tuberculosis by using MPB64 - ICA in BALF, but how to reduce the false positive and negative, it would require further research.