肺结核的LAM-IgG阳性病人两年的随访报告

A two-year followup report on the LAM-IgG positive patients with pulmonary tuberculosis.

目的 探讨菌阴性肺结核 L AM- Ig G抗体持续两年阳性的临床意义。方法 对进展期肺结核 190例 ;其中菌阴组 111例(初治 84、复治 2 7例 ) ,菌阳组 79例 (初治 48、复治 31例 ) ;检测 L AM- Ig G抗体。并对 L AM- Ig G阳性者进行两年后随访。结果 L AM- Ig G抗体阳性率分别为 :菌阴组 :72 .97% (81/ 111)。菌阳组 :89.87% (71/ 79)。X2 =8.2 4P<0 .0 5有显著性。初治、复治病人的 L AM- Ig G阳性率比较 :菌阴组 :初治 6 6 .6 7% (5 6 / 84)和复治 92 .5 9% (2 5 / 2 7) ,菌阳组 :初治 87.5 0 % (42 / 48)和复治 93.5 5 % (2 9/31)。随访 133例抗体阳性肺结核病人 ,两年后阴转率为 46 .6 2 % (6 2 / 133) :菌阴组阴转率 76 .81% (5 3/ 6 9) ,菌阳组阴转率是 :14.0 6 % (9/ 6 4)。结论 L AM- Ig G抗体持续两年阳性在菌阳复治病人中多见。对菌阴性肺结核而言 ;

Objective To explore clinical significance of pulmonary tuberculosis patients who had sputum bacillus negative and had LAM IgG antibodies positive in the past 2 years.Method One hundred and ninty cases with advanced pulmonary tuberculosis were measured on LAM IgG antibodies.There were 111 cases the (initial treatment of 84 cases and the recurrent treatment of 27 cases) in the sputum bacillus negative group and 79 cases (initial treatment of 48 cases and the recurrent treatment of 31 cases) in the sputum bacillus positive group.LAM IgG positive patients were followed for two years.Results The positive rates of LAM IgG antibodies in the sputum bacillus negative group and in the positive group were 72.9%(81/111) and 89.87%(71/79),respectively:X 2=8.24,P<0.05.The positive rates of LAM IgG antibodies for the initial treatment patients and for the recurrent treatment patients were 66.67%(56/84) and 92.59%(25/27),respectively. In the sputum bacillus positire group:87.5%(42/48) and 93.55%(29/31),respectively.One hundred thirty three cases whose LAM IgG antibodies were positive were followed.At the end of the two years,the percentage of LAM IgG antibodies that changed from being positive to negative was 46.62%(62/133):76.81%(53/69) in the sputum bacillus negative group and 14.06(9/64) in the sputum bacillus positive group.Conclusions The two year followup study showed that LAM IgG antibodies being positive occurred frequently among the recurrent treatment patients whose sputum bacillus was positive. For the patients whose sputum bacillus was negative,LAM IgG antibody being positive suggested that tuberculosis bacillus might resist drugs.