结核蛋白芯片2.docVIP

结核蛋白芯片检测对结核病诊断的价值 段慧萍 郭东菊 (太原市结核病医院内一科，030053) [摘要]目的：探讨结核蛋白芯片检测对诊断结核病的价值。方法：回顾以结核蛋白芯片系统检测血清中结核菌蛋白16KDa和38KDa以及脂阿拉伯甘露糖三种抗体的病例561例，其中结核病例504例，非结核病例57例，分析其结果。结果： 504例结核病人中共194例结核抗体阳性，57例非结核病例2例阳性，结核蛋白芯片检测的灵敏度为38.5%, 特异度为96.5％。不同类型结核病阳性率不同，痰结核菌培养阳性肺结核结核抗体阳性率61.2％，痰培养阴性的肺结核阳性率45.7％，结核性脑膜炎阳性率29.9%，结核性胸膜炎阳性率23.3％，骨结核27.3%。结论：结核蛋白芯片是诊断结核病的较有效方法，具有特异性好，快速方便等优点，尤其对肺结核快速辅助诊断起积极作用，但在结核性胸膜炎、脑膜炎和以及骨结核中阳性率偏低，敏感性稍差。 关键词：结核分枝杆菌，蛋白芯片，抗体 Clinical value of tuberculosis Protein chip in diagnosis of tuberculosis Duan Huiping,Guo Dongju (Dept of Internal Medicine,Taiyuan Tuberculosis Hospital，Taiyuan 030053,China) Abstract:Objective To explore the diagnosis value of tuberculosis protein chip for tuberculosis. Methods Retrospectively analyze the antibody levels of tuberculoprotein 16kD,38kD and LAM were detected by Protein Chip. Of 561 cases, there were 504 tuberculosis cases and 57 non-TB cases. Results Of 504 tuberculosis cases , there were 194 cases tuberculosis antibody were positive, there were 2 cases were positive in 57 non-TB cases. The sensitivity of uberculosis protein chip was 38.5%,the specificity was 96.5％. The different type tuberculosis positive rate is different.Sputum-culture-positive tuberculosis positive rate is 61.2%, and sputum-culture -negative tuberculosis was 45.7%.Tuberculous meningitis positive rate was 29.9%, positive rate of pleurisy was 23.3%, Bones tuberculosis was 27.3% and 3.5% in the non-TB cases. Conclusion The tuberculosis protein chip is a fast, easy and effective method for diagnosing the tuberculosis with good specificity, especially for the rapid diagnosis of pulmonary tuberculosis. But it is less sensitive for Pleurisy, meningitis and Bones tuberculosis. Key words: Mycobactedum Tuberculosis；Protein Chip ；Antibody 结核病是长期以来危害人类生命健康的严重疾患，我们国家疫情严重，患者数约450万，每年病死近20万人[1]。结核病的病原体为结核杆菌，它除了能引起肺结核外，还可引起其他部位的病变，结核病的早期快速诊断对结核病的防治具有极其重要的意义。在诊断结核病时，结核菌的培养最为准确，但是耗时长，为临床诊断带来不便。很多临床医生对结核病的血清学诊断寄予厚望。近年，使用基因工程表达的结核菌蛋白16KDa和38KDa以及脂阿拉伯甘露糖(LAM)三种抗原制作的结核蛋白芯片联合检测结核抗体，在临床