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检测外周血特异性结核分枝杆菌抗体对活动性结核病的诊断价值研究 被引量:4

Study on diagnostic value for active tuberculosis by detecting Mycobacterium tuberculosis-specific antibodies in the peripheral blood
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摘要 目的研究外周血浆细胞分泌特异性结核分枝杆菌抗体对活动性结核病的诊断价值。方法纳入2013年4月至7月期间深圳市第三人民医院肺科门诊活动性结核病患者;健康对照组人员来自体检科门诊志愿者,分为3个组:活动性结核病组(104例)、结核分枝杆菌(Mtb)潜伏感染组(26例)和健康对照组(33名)。分离其外周血单个核细胞(PBMCs)。体外培养4d后收集培养上清液,用ELISA法和蛋白免疫印迹法,ELISA和蛋白免疫印迹法检测外周血浆细胞分泌的特异性结核分枝杆菌抗体;检测各组收集的PBMCs培养上清液中的特异性结核分枝杆菌抗体,比较各组间的差异。所有数据均使用GraphPadPrism5.0进行统计学分析,用受试者工作特征(ROC)曲线评价ELISA法检测的诊断价值,得出敏感度、特异度;多组间的比较采用Kruskal—Wallis检验;两组间比较采用Dunnmultiplecomparison检验;蛋白免疫印迹法用四格表的卡方检验;以P〈0.05为差异有统计学意义。结果ELISA法检测活动性结核病组特异性结核分枝杆菌抗体的A450nm值(0.593±0.206)高于Mtb潜伏感染组(0.342±0.152)和健康对照组(0.246±0.121),差异有统计学意义(H=77.27,P〈0.001)。特异性结核分枝杆菌抗体区分活动性结核病患者和Mtb潜伏感染者、健康对照者曲线下面积(AUC)分别为0.857、0.944,当诊断界限值为0.42时,其区分活动性结核病和Mtb潜伏感染的敏感度为77.9%(81/104),特异度为80.8%(21/26);区分活动性结核病和健康人的敏感度为77.9%(81/104),特异度为93.9%(31/33)。蛋白免疫印迹法检测活动性结核病和健康人的敏感度、特异度和准确性分别为79.2%(61/77)、100.0%(11/11)、81.8%(72/88)(x2=24.8,P〈0.001)。结论ELISA法和蛋白免疫印迹法检测外周血浆细胞分泌特异性结核分枝杆菌抗体诊断活动性结核病特异度高,可以作为临床结核病实验诊断的辅助方法。 Objective To evaluate the diagnostic value for active tuberculosis (TB) by detecting antibodies secreted from Mycobacterium tuberculosis-specific plasma ceils in peripheral blood. Methods The study period was from April 2013 to July 2013, and the study sample included 3 groups of subjects: 104 patients with active TB; 26 cases with latent TB infection (LTBI) ; and 33 healthy volunteers as a control group. The active TB patients were enrolled from the Outpatient Department of Shenzhen 3rd People's Hospital while the LTBI and healthy volunteers were enrolled from Health Examination Clinic of Shenzhen 3rd People's Hospital. Peripheral blood mononuclear cells (PBMCs) from all study subjects were isolated and cultured in vitro for 4 days, and then the supernatants of each group were collected. Mycobacterium tuberculosis specific antibodies in lymphocyte supernatant were tested by ELISA and Western blot and the differences among the three groups were analyzed. GraphPad Prism 5.0 was used for data analysis. The diagnostic value of EI.ISA was evaluated by receiver operating characteristic (ROC) curve. The Kruskal-Wallis test was used for comparison among multi-groups and the Dunn muhiple comparison test was used for comparison between two groups. The difference was considered to be statistically significance if the P-value was 〈0.05. Results The A450nm value of Myeobacterium tuberculosis-specific antibodies measured by ELISA was higherin the group of patients with active TB (0. 593±0. 206) than those in the group of cases with I.TBI (0. 342±0. 152) and in the group of healthy persons (0. 246±0. 121) respectively, the differences had statistically significance (H=77.27, P〈0. 001). Areas under the curve (AUC) of Mycobacterium tuberculosis-specific antibodies which used for distinguish active rib and LTBI, active TB and healthy person were 0. 857 and 0. 944 respectively; when the value of 0.42 was used as a diagnostic threshold, the sensitivity and specificity for districting active TB and LTBI were 77.9% (81/104) and 80. 80% (21/26) respectively, and sensitivity and specificity for distinguishing active TB and health people were 77.9%(81/104) and 93.9% (31/33) respectively. The sensitivity, specificity, and accuracy of Western blot test in detecting active TB patients and healthy person were respectively 79.2 % (61/77), 100.0% (11/11) and 81.8% (72/88) (x2 =24.8, P〈0. 001). Conclusion The specificity of both EI.ISA and Western blot tests are high in detecting Mycobacterium tuberculosis specific antibodies secreted from peripheral blood plasma cells, so they can be used for diagnosis of active TB as new methods in clinical laboratory.
出处 《中国防痨杂志》 CAS 2014年第5期356-361,共6页 Chinese Journal of Antituberculosis
基金 基金项目:广东省医学科学技术研究基金(A2013592) 深圳市科技创新委项目(2013129)
关键词 结核诊断 分枝杆菌 结核 抗体 细菌 白细胞 单核 Tuberculosis diagnosis Mycobacterium tuberculosis Antibodies, bacterial Leukocytes, mononuclear
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  • 1World Health Organization. Global tuberculosis report 2012. Geneva: World H eahh Organization, 2013.
  • 2Tarlinton D, Radbruch A, Hiepe F, et al. Plasma cell differen- tiation and survival. Curr Opin Immunol, 2008, 20 (2): 162-169.
  • 3Oracki SA, Walker JA, Hibbs ML, et al. Plasma cell develop ment and survival. Immunol Rev, 2010,237(1) : 140-159.
  • 4Raqib R, Kamal SM, Rahman MJ, et al. Use of antibodies in lymphocyte secretions for detection of subclinical tuberculosis infection in asymptomatic contacts. Clin Diagn Lab Immunol, 2004,11(6) : 1022- 1027.
  • 5Raqih R, Mondal D, Karim MA, et al. Detection of antibodies secreted from circulating Mycobacterium tuben:ulosis-specific plasma cells in the diagnosis of pediatric tuberculosis. Clin Vaccine Immunol, 2009,16 (4) : 521-527.
  • 6Rekha RS, Kamal SM, Andersen P, et al. Validation of the ALS assay in adult patients with culture confirmed pulmonary tu- berculosis. PLoS One, 2011,6 ( 1 ) : e16425.
  • 7Thomas T, Brighenti S, Andersson J, et al. A new potential bio marker for childhood. Thorax,2011,66(8) :727 -729.
  • 8Ashenafi S, Aderaye G, Zewdie M, et al. BCG-specific IgC-se creting peripheral plasmahlasts as a potential biomarker of ac- tive tuberculosis in HIV negative and HIV positive Patients. Thorax,2013,68(3) :269-276.
  • 9Yan L, Qiu J, Chen J, et al. Selected prfA * mutations in re- combinant attenuated Listeria monocytogenes augment expres- sion of foreign immunogens and enhance vaccine-elicited hu moral and cellular immune responses. Infect Immun, 2008,76 (8) :3439-3450.
  • 10阳幼荣,王全立,吴雪琼,梁艳,张俊仙.结核分枝杆菌12种抗原在结核病血清学诊断中应用价值的研究[J].中国防痨杂志,2011,33(8):486-491. 被引量:9

二级参考文献20

  • 1李云伏.优质玉米的发展战略及品种主要类型[J].农业新技术,2002(4):4-6. 被引量:7
  • 2王海英,于春宝,王燕,王新锋,高绪胜,刘志敏.TB-SA抗体检测对结核病临床诊断价值的研究[J].中国防痨杂志,2008,30(1):33-36. 被引量:21
  • 3杨勇杰,姜瑞芝,陈英红,张萍,高其品.苯酚硫酸法测定杂多糖含量的研究[J].中成药,2005,27(6):706-708. 被引量:130
  • 4Sambrook J,Fritsch EF,Maniatis T.分子克隆实验指南.金冬雁,黎孟枫译.2版.北京:科学出版社,1999:845-848,896.
  • 5Chan ED, Heifets L, Iseman MD. Immunologic diagnosis of tubereulosis:areview. Tuber LungDis,2000,80(3):131- 140.
  • 6Daniel TM, Debanne SM. The serodiagnosis of tuberculosis and other mycobacterial diseases by enzyme-linked immunosorbent assay. Am RevRespir Dis,1987,135(5):1137-1151.
  • 7Lyashchenko K, Colangeli R, Houde M, et al. Heterogeneous antibody responses in tuberculosis. Infect Immun, 1998, 66 (8):3936-3940.
  • 8Wu X, Yang Y, Zhang J, et al. Humoral immune responses a gainst the Mycobacterium tuberculosis 38 kilodalton, MTB48 and CFP 10/ESAT-6 antigens in tuberculosis. Clin Vaccine Im munol, 2010,17(3) :372-375.
  • 9Hendrickson RC, Douglass JF, Reynolds LD,et al. Mass spec- trometric identification of MtbS1, a novel serological marker for tuberculosis. J Clin Microbiol,2000,38(6):2354-2361.
  • 10Pottumarthy S, Wells VC, Morris AJ. A comparison of seven tests for serological diagnosis of tuberculosis. Clin Microbiol, 2000,38(6):2227-2231.

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