血清结核杆菌特异性抗原对诊断结核病中作用探讨.docVIP

血清结核杆菌特异性抗原对诊断结核病中作用探讨 　　摘要：目的： 从人血清提取 ESAT6、CFP10-ESAT6、ESAT6-PPE68为包被进行抗原检测，探讨结核病诊断新方法。方法： 利用本室构建并纯化的结核分枝杆菌特异性抗原蛋白 ESAT6、CFP10-ESAT6、ESAT6-PPE68，建立结核分枝杆菌特异性抗体检测的间接 ELISA 检测方法， 并与 PPD-ELISA 同时检测 220 例结核病人血清、30 例非结核呼吸疾病病人血清和 50 例健康人群血清，分别对三种方法的敏感性与特异性进行统计学分析。 结果： ESAT6-ELISA 的敏感性为 25%，特异性为 95%；CFP10-ESAT6-ELISA 的敏感性为 45%，特异性为 93%；ESAT6-PPE68-ELISA 的敏感性为 48%，特异性为 85%。 结论： 三种结核分枝杆菌特异性抗体检测方法的敏感性均低于 PPD-ELISA，但三种结核分枝杆菌特异性抗体检测方法的特异性均高于 PPD-ELISA， 其中 CFP10-ESAT6-ELISA 检测的效果最佳，PPE68 可作为结核特异性诊断的候选抗原。 　　关键词：结核分枝杆菌；ESAT6；CFP10；PPE68；ELISA 　　Abstract： Objectiv To seek new methods for detection of Mycobacterium tuberculosis by detection of ESAT6，CFP10-ESAT6，ESAT6-PPE68. Methods By employing the specific antigens of Mycobacterium tuberculosis ESAT6，CFP10-ESAT6 and ESAT6-PPE68，cloned，expressed and purified by our lab，we have established three indirect ELISA methods to detect specific antibodies of Mycobacterium tuberculosis：ESAT6-ELISA，CFP10-ESAT6-ELISA and ESAT6-PPE68-ELISA.220 patients with tuberculosis，30 patients with non-tuberculosis lung disease and 50 healthy humancontrols were analyzed simultaneously with PPD-ELISA，and the sensitivity and the specificity of the three differentmethods are evaluated.Results The sensitivity of ESAT6-ELISA is 25%，with specificity of 9%，the sensitivity of CFP10-ESAT6-ELISA is 45%，with specificity of 93%；the sensitivity of ESAT6-PPE68-ELISA is 48%，with specificityof 85%.Conclusions Compared with PPD-ELISA，the sensitivity of the three ELISA methods developed by our lab lower than that of PPD-ELISA，but the specificity of the three ELISA methods developed by our lab is higher than that of PPD-ELISA， and CFP10-ESAT6-ELISA is the best. PPE68 is a specific antigen which has crucial importancefor detection of tuberculosis. 　　Keywords： Mycobacterium tuberculosis；ESAT6；CFP10；PPE68；ELISA 　　结核病作为一种慢性传染性疾病，近年来发病率有上升趋势，临床上认为结核分枝杆菌引发呼吸道慢性传染是结核病发病的根源，由于其较高的感染率与耐药性，因此结核病的快速诊断对于结核防治有着重要的作用，但至今尚没有一种准确、快速、可靠的检测结核分枝杆菌感染的方法。结核菌素纯化蛋白衍生物（PPD）是从结核分枝杆菌培养滤液中获得的复杂蛋