结核性脑膜炎早期诊断的比较研究-神经病学专业论文.docxVIP

复旦大学硕士研究生论文摘要 复旦大学硕士研究生论文 摘要 为评价和比较酶联免疫斑点法(enzymelinkedimmunospotassayELISPOT)、 聚合酶链反应(polymerase chain reaction PCR)及酶联免疫吸附法(enzyme linked immunosorbent assay ELISA)对结核性脑膜炎(tuberculous meningitis TBM)早期诊 断的价值，收集了13例临床确诊的TBM患者的29对脑脊液(cerebrospinal fluid CSF)及外周血标本，40例其它中枢神经系统感染和非感染性神经系统疾病患者 的40对标本。分别运用ELISPOT检测CSF和外周斑的BCG抗体分泌细胞，PCR检 测CSF中结核杆菌的DNA，ELISA检测CSF相对于外周血的BCG抗体水平。结果 显示：ELISPOT检测csF BCG．IgG分泌细胞，在疾病早期(第2周)即呈现明显 的阳性结果，敏感性为92．3％，特异性为97．5％，全部实验在24／]时内完成，对 TBM的早期诊断有很高价值；IS6110PCR检澳4csF中的结核杆菌DNA，敏感性 为84．6％，特异性为100％，64,时可出结果，但是容易污染而导致假阳性，若具 各合格的实验室条件，对TBM的早期诊断亦有一定价值；ELISA敏感性仅为 53．80／0，特异性为1000,6，至少需48,J,时出结果，不宜作为TBM的常规诊断方法。 关键词：结核性脑膜炎，ELISPOT，PCR，ELISA 中图分类号：R529．3 复旦大学硕士研究生论文To 复旦大学硕士研究生论文 To evaluate and compare enzyme linked immunospot assay(ELISPOTl． polymemse chain reaction(PCR)．and enzyme linked immunosorbent assay(ELISA) in early diagnosis of toberculOUS merlingitis(TBM)，29 pairs of cerebrospinal fluid(CSF)and serum from 13 clinically diagnosed TBM patients and 40 pairs of contr01 samDles were collected．We used EUSPOT to deteet BCG anfibody secreting cells in CSF and serum．PCR to detect DNA ofMycobacterium tuberculosis in CSFs and ELISA to detect BCG antibody in CSF comparing to that of seruln．Sensifivity of ELISPOT was 92 3％．obviOtis positive results were achieved in 2 weeks after onset of the disease．We argued that ELISPOT presented a useful method in early diagnosis of TBM The sensitiv曲of PcR was 84．6％，and the specificity WaS 100％．The result turned out within 6 hours but contamination WaS a big problem We suggested that with qualified experimental conditions．PCR al,SO had certain valHe in early diagnosis of TBM．Elisa had a Sensitivity of 53 8％and a specificity of 100％．The whole experiment took 48 hours．Our results demonstrated that ELISA was not suitable to sere as a routine method for diagnosis ofTBM． Key Words：tuberculous meningitis，ELISPOT，PCR，ELISA 本文常用缩略词TBM 本文常用缩略词 TBM tuberculous meningitis 结核性脑膜炎 ～mlR multidrugs resistant 多药耐药 PCR polymerase chain