[不同分枝杆菌抗原在结核病诊断中的临床意义]

[Clinical significance of different mycobacterial antigens in diagnosis of tuberculosis].

作者信息

Gao M, Tian M

机构信息

Beijing Tuberculosis and Thoracic Tumor Institute, Beijing 101149.

出版信息

Zhonghua Jie He He Hu Xi Za Zhi. 1999 Oct;22(10):613-5.

PMID:11776552

Abstract

OBJECTIVE

To evaluate the significance of different mycobacterial antigens in diagnosis of tuberculosis.

METHODS

The sensitivity and specificity of 5 mycobacterial recombinant proteins in diagnosis of tuberculosis were observed by using ICT-TB card and the results of ICT-TB card were compared with PPD skin test and LAM.

RESULTS

The sensitivities of ICT-TB card, LAM and PPD skin test in diagnosis of pulmonary tuberculosis were 55.9%, 52.6% and 75.0% respectively. There was statistically significant difference between the latter and the other two (P < 0.05). The specificities of ICT-TB card, LAM and PPD skin test in diagnosis of pulmonary tuberculosis were 87.6%, 62.9% and 68.9% respectively. There was statistically significant difference between the former and the other two. The clinical positive predictive value in diagnosis of pulmonary tuberculosis was 88.5%; the clinical negative predictive value was 53.8%. The positive reactions of ICT-TB in non-tuberculosis were caused mainly by antigens 4, 5, and if antigens 4, 5 were excluded, the specificity of ICT-TB card rose to 98.9%.

CONCLUSIONS

The results suggested that measuring mycobacterial recombinant proteins was a useful supplementary tool for diagnosis of pulmonary tuberculosis.

摘要

目的

评估不同分枝杆菌抗原在结核病诊断中的意义。

方法

采用ICT-TB卡观察5种分枝杆菌重组蛋白在结核病诊断中的敏感性和特异性，并将ICT-TB卡结果与PPD皮肤试验和LAM结果进行比较。

结果

ICT-TB卡、LAM和PPD皮肤试验诊断肺结核的敏感性分别为55.9%、52.6%和75.0%。后者与前两者之间存在统计学显著差异（P<0.05）。ICT-TB卡、LAM和PPD皮肤试验诊断肺结核的特异性分别为87.6%、62.9%和68.9%。前者与后两者之间存在统计学显著差异。诊断肺结核的临床阳性预测值为88.5%；临床阴性预测值为53.8%。ICT-TB在非结核患者中的阳性反应主要由抗原4、5引起，若排除抗原4、5，ICT-TB卡的特异性升至98.9%。