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[肺结核的血清学诊断。临床评估]

[Serodiagnosis in pulmonary tuberculosis. Clinical evaluation].

作者信息

Sánchez Montón T, Martín Luengo F

机构信息

Servicio de Medicina Interna, Hospital General Universitario de Murcia.

出版信息

Enferm Infecc Microbiol Clin. 1992 May;10(5):267-71.

PMID:1390995
Abstract

The IgA, IgG, IgM and IgG subsets antibodies levels were determined in 200 patients with pulmonary tuberculosis and compared to three control groups: 80 healthy individuals (50 with negative PPD skin test, 30 with positive PPD skin test), 30 leprosy patients and 20 patients with different pulmonary diseases. The technique used was an enzyme linked assay. As antigens, purified tuberculin and Ag60 from M. bovis were used. There were not statistically significant differences between antibody levels among all control groups studied, but when we compare the level in control groups with that observed in tuberculous patients, they showed higher levels of IgA, IgG, IgM, IgG2 (p less than 0.01) and IgG4 (p less than 0.05). A definite diagnosis of tuberculosis of the lung should only be established if the patient showed to be positive to IgG plus IgA or IgM and in special cases to IgG1, reaching then a diagnostic efficacy of 90% in a patient population with a 68% of positive smears for acid-fast bacilli.

摘要

测定了200例肺结核患者的IgA、IgG、IgM和IgG亚群抗体水平,并与三个对照组进行比较:80名健康个体(50名PPD皮肤试验阴性,30名PPD皮肤试验阳性)、30名麻风病患者和20名患有不同肺部疾病的患者。所采用的技术是酶联免疫吸附测定法。以纯化结核菌素和牛分枝杆菌的Ag60作为抗原。在所研究的所有对照组之间,抗体水平无统计学显著差异,但当我们将对照组的水平与肺结核患者中观察到的水平进行比较时,他们的IgA、IgG、IgM、IgG2(p<0.01)和IgG4(p<0.05)水平更高。只有当患者的IgG加IgA或IgM呈阳性,在特殊情况下IgG1呈阳性时,才能确诊为肺结核,此时在痰涂片抗酸杆菌阳性率为68%的患者群体中诊断效率可达90%。

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