结核抗体lgG/lgM检测在肺结核和肺外结核中的诊断价值

IgG and IgM antibodies detection for pulmonary and extrapulmonary tuberculosis diagnosis

目的探讨异种血清抗体检测技术在结核病诊断中的应用价值。方法采用IgG/IgM抗体试剂盒分别检测102例结核病患者(包括73例肺结核和29例肺外结核)、223例其他肺部疾病患者和100例对照者结核感染情况,以临床诊断为标准评价该方法的敏感度和特异性,同时分别与痰菌培养及痰涂片平行检验的结果作比较,统计学分析采用χ2检验。结果结核抗体IgG/IgM检测结核病患者的敏感度为74.51%、特异度为91.64%。结核抗体IgG/IgM检测肺结核和肺外结核的敏感度分别为82.19%、55.17%,肺内和肺外结核的敏感度差异有统计学意义(P<0.05),结核抗体lgG/IgM检测结核患者阳性检出率明显高于痰培养法和痰涂片法(P<0.05)。102例结核病患者年龄段分组分析,少年组和老年组检出率分别为58.33%、36%,远低于青年组和中年组的96.15%和89.74%。不同年龄组间进行卡方比较分析显示,P<0.05,差异有统计学意义。425例标本中,共发现8例非结核分枝杆菌,其中6例胞内分枝杆菌,2例脓肿分枝杆菌,lgG/lgM抗体检测均为阴性。结论 IgG/IgM血清抗体检测肺内、外结核具有快速方便、经济和较高的敏感度,适合用于临床结核筛查。

To evaluate the diagnostic value of heterologous serum antibody for tuberculosis, we detected the serum spec- imens from 102 patients with tuberculosis （included 73 pulmonary TB and 29 extrapulmonary TB）, 223 patients with other re- spiratory diseases and 100 healthy people were enrolled into the study. Results of clinical diagnosis as the golden standard were used to evaluate sensitivity and specificity of the tuberculosis antibody. Tuberculosis antibody （IgG/IgM）, sputum bacterial culture and sputum smear were used to test M. tuberculosis infection parallelly. Results were compared by chi-square test. Re- sults showed that the sensitivity and specificity of IgG/IgM tuberculosis antibodies in diagnosis of tuberculosis were respectively 74.51 % and 91.64%. The sensitivity of IgG/IgM tuberculosis antibodies in diagnosis of pulmonary and extrapulmonary tuber- culosis were respectively 82.19 % and 55.17 %, which were significant differences between the positive detection rate of pulmo- nary tuberculosis and extrapulmonary tuberculosis （P〉0.05）. The positive rate of IgG/IgM tuberculosis antibodies was higher than those in sputum culture and sputum smear （P〈0.05）. A total of 102 cases of tuberculosis in patients in different age groups were analyzed, and the positive detection rate of children and elderly group were 58.33% and 36%, respectively, which were far below the rate in the youth group （96. 15%） and the middle-aged group （89.74%）. The chi-square value for the differences in age group in the sensitivity of IgG/IgM tuberculosis antibodies was significant difference （P〈0.05）. Six out of 425 cases of specimens were found as M. intracellulare, and 2 as M. abscessus. However, the IgG/IgM tuberculosis antibodies were negative in diagnosis of non-tuberculous mycobacteria. Antibody （IgG/IgM） is sensitive, rapid, convenient, and easy to manipulate the screening of tuberculosis.