评价多种抗原在非典型脊柱结核辅助诊断中的作用

Combined detection of multiple antigens in the diagnosis of atypical spinal tuberculosis

采用ELISA法检测63例疑似非典型脊柱结核患者和30例健康体检者血清中结核杆菌热休克蛋白10(MTB Hsp10)、结核杆菌热休克蛋白60(MTB Hsp 60)、热休克蛋白16.3(Hsp 16.3)和热休克蛋白70(Hsp 70)吸光度(OD)值,探讨这4种抗原在非典型脊柱结核辅助诊断中的作用。非典型脊柱结核组血清中4种抗原OD值高于脊柱其他疾病组和健康体检组(P<0.05);MTB Hsp 10、MTB Hsp 60、Hsp16.3、Hsp 70的诊断灵敏度和特异度分别是87%、89%、70%、51%和73%、75%、84%、91%,4种抗原联合诊断灵敏度和特异度是89%、98%;通过绘制受试者工作特征(ROC)曲线显示4种抗原中MTB Hsp 10和MTB Hsp 60的曲线下面积(AUC)最大(分别为0.85、0.88),4种抗原联合诊断时AUC=0.97(P<0.001)。4种抗原对非典型脊柱结核的辅助诊断具有一定意义,联合诊断价值更高。

ELISA was used to detect the optical density（ OD） values of Mycobacterium tuberculosis heat shock protein 10（ MTB Hsp10）,Mycobacterium tuberculosis heat shock protein 60（ MTB Hsp60）,heat shock protein 16. 3（ Hsp16. 3） and heat shock protein 70（ Hsp70） level in 63 cases with suspected atypical spinal tuberculosis and 30 healthy volunteers,to explore the role of four antigens in the diagnosis of atypical spinal tuberculosis. The OD values of four antigens in serum of atypical spinal tuberculosis were higher than that in the other spinal diseases group and health control group（ P〈0. 05）. The diagnostic sensitivity and specificity of MTB Hsp10,MTB Hsp60,Hsp16. 3 and Hsp70 were 87%,89%,70%,51% and 73%,75%,84%,91%,respectively. The sensitivity and specificity of combined four antigens were 89% and 98%. The plot of receiver operating characteristic（ ROC） plots showed that the area under the curve（ AUC） of MTB Hsp 10 and MTB Hsp 60 among the four antigens was the highest（ 0. 85 and 0. 88,respectively） and the AUC was 0. 97（ P 0. 001）. Combined detection of four antigens on the diagnosis of atypical spinal tuberculosis is more valuable.