结核性脑膜炎患者早期分泌性抗原-6和特异度抗原培养滤液蛋白-10水平变化及意义

The changes of early secreted antigenic target and cultrue filtrate protein-10 in patients with tuberculous meningitis and its clinical significances

目的监测结核性脑膜炎(TBM)患者结核分枝杆菌早期分泌性抗原-6(ESAT-6)和特异度抗原培养滤液蛋白-10(CFP-10)的动态变化并评估其临床意义。方法收集2013年1月-2016年12月在台州市第一人民医院治疗的结核性脑膜炎患者39例(TBM组)和非结核性脑膜炎53例(对照组)。同时,采用酶联免疫吸附法(ELISA)检测脑脊液中ESAT-6和CFP-10水平。结果 TBM组患者ESAT-6、CFP-10水平均高于对照组,差异有统计学意义(P<0.05)。ESAT-6诊断TBM的灵敏度、特异度和ROC曲线下面积(AUC)分别为79.5%、90.6%、0.922。CFP-10诊断TBM的灵敏度、特异度和AUC分别为87.2%、86.8%、0.894。随着疾病的进展,TBM患者ESAT-6、CFP-10水平逐渐下降,且治疗3个月后,TBM组患者ESAT-6、CFP-10水平与对照组比较差异无统计学意义(P>0.05)。结论 ESAT-6和CFP-10可以作为结核性脑膜炎的快速、准确的诊断指标。

Objective To monitor dynamic changes and assess its clinical significances of early secreted antigenic target 6（ ESAT-6） and cultrue filtrate protein 10（ CFP-10） in patients with tuberculous meningitis（ TBM）. Methods 39 patients with tuberculous meningitis（ TBM group） and 53 patients without of tuberculous meningitis（ control group） from January 2013 to December 2016 in the first people＇s hospital of Taizhou were collected. Meanwhile,enzyme linked immunosorbent assay（ ELISA）method was used to detect ESAT-6 and CFP-10 levels in the cerebrospinal fluid. Results The ESAT-6 and CFP-10 levels were significantly higher in TBM group than that in control group and the difference was statistically significant（ P〈0. 05）.The sensitivities,specificities,and area under the ROC curve（ AUC） of ESAT-6 in diagnosing TBM were 79. 5%,90. 6%,0. 922. The sensitivities,specificities,and AUC of CFP-10 in diagnosing TBM were 87. 2%,86. 8%,0. 894. The levels of ESAT-6 and CFP-10 of patients with TBM decreased gradually in the progression of the disease,and the differences in the levels of ESAT-6 and CFP-10 between TBM group and control group after three months of treatment were statistically significant（ P〉0. 05）. Conclusion ESAT-6 and CFP-10 can be used as rapid and accurate diagnostic criteria for tuberculous meningitis.