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[酶免疫测定法在结核病诊断中的实用性]

[Usefulness of the enzyme immunoassay in the diagnosis of tuberculosis].

作者信息

de Kantor I N, Barrera L, Ritacco V, Miceli I

机构信息

Centro Panamericano de Zoonosis (CEPANZO, OPS/OMS), Buenos Aires, Argentina.

出版信息

Bol Oficina Sanit Panam. 1991 Jun;110(6):461-70.

PMID:1831026
Abstract

To assess the usefulness of enzyme immunoassay as a rapid method of diagnosing tuberculosis, a study was conducted of 687 serum samples from 271 children and 416 adults. With 55 sera from nontuberculous children as controls, the specificity was 0.98, and with 137 controls from the adult population, 0.93. Prior vaccination with BCG did not influence the level of detectable anti-PPD antibody. The results were similar in healthy PPD-positive and negative adults. The test differentiated mycoses and nontuberculous mycobacterioses from tuberculosis. The sensitivity rates in 49 children and 200 adults diagnosed with bacteriologically confirmed pulmonary and extrapulmonary tuberculosis were calculated at 0.51 and 0.69, respectively. In those tuberculosis cases not bacteriologically confirmed or at other sites, the test was positive in 28.1% of 114 children and in 48.6% of 35 adults. The cost, speed, and availability of reagents for this test were comparable to those for direct microscopic examination. Both methods were positive for 49% of the tuberculosis cases confirmed by culture, and a total of 84% of those cases were found positive using one method or the other. It is concluded that enzyme immunoassay can be especially useful in the rapid diagnosis of nonbacilliferous pulmonary, extrapulmonary, and childhood tuberculosis.

摘要

为评估酶免疫测定法作为一种快速诊断结核病方法的实用性,对来自271名儿童和416名成人的687份血清样本进行了一项研究。以55份非结核儿童血清作为对照,特异性为0.98;以137份成人对照血清,特异性为0.93。先前接种卡介苗不影响可检测到的抗PPD抗体水平。在健康的PPD阳性和阴性成人中结果相似。该试验能区分真菌病、非结核分枝杆菌病与结核病。在49名儿童和200名经细菌学确诊为肺结核和肺外结核的成人中,敏感性分别计算为0.51和0.69。在那些未经细菌学确诊或其他部位的结核病例中,该试验在114名儿童中的阳性率为28.1%,在35名成人中的阳性率为48.6%。该试验的成本、速度和试剂可用性与直接显微镜检查相当。两种方法对经培养确诊的结核病例的阳性率均为49%,且总共84%的病例使用其中一种方法或另一种方法检测为阳性。结论是酶免疫测定法在快速诊断无杆菌性肺结核、肺外结核和儿童结核病方面可能特别有用。

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