Li F T
Shanghai Zunyi Hospital, Shanghai.
Zhonghua Jie He He Hu Xi Za Zhi. 1990 Feb;13(1):36-8, 62-3.
The serum antibody to lipoarabinomannan-B(LAM-B) purified from mycobacterium tuberculosis (H37Ra) was tested by ELISA in 250 sera, including sera from patients as follows: tuberculosis 96, tubercular pleurisy 11, renal tuberculosis 2, bone and joint tuberculosis 33, tubercular meningitis 16, pulmonary cancer 22, leprosy 20 and normal subjects 50. The positive rate of pulmonary tuberculosis is 69.8%, which is of a similar extent in sera from patients with tuberculosis of miscellaneous organs to be tested except tubercular meningitis, in which only 18.8% positive rate was observed, indicating the blockage of antibody releasing from pathologic foci into blood stream by blood-brain barrier. The positive rates of leprosy and normal subjects are 50.0% and 2.0% respectively. No antibody was found among 22 patients with pulmonary cancer. It is suggested that the existence of an active tubercular lesion in the host might be the basic prerequisite for a positive LAM-B antibody detection. Although LAM-B is a common antigen of both mycobacterium tuberculosis and mycobacterium leprae, the low prevalence of leprosy in China makes little influence of the practicability of using this ELISA in epidemiological study and in clinic as a adjutant tool for tuberculosis diagnosis and differential diagnosis.
采用酶联免疫吸附测定法（ELISA）检测了从结核分枝杆菌（H37Ra）中纯化的脂阿拉伯甘露聚糖-B（LAM-B）的血清抗体，检测对象为250份血清，包括以下患者的血清：肺结核患者96例、结核性胸膜炎患者11例、肾结核患者2例、骨与关节结核患者33例、结核性脑膜炎患者16例、肺癌患者22例、麻风病患者20例以及正常受试者50例。肺结核患者的阳性率为69.8%，除结核性脑膜炎外，待检测的其他各器官结核患者血清中的阳性率与之相近，结核性脑膜炎患者血清的阳性率仅为18.8%，这表明血脑屏障阻碍了抗体从病灶释放进入血流。麻风病患者和正常受试者的阳性率分别为50.0%和2.0%。22例肺癌患者中未发现抗体。提示宿主存在活动性结核病灶可能是检测LAM-B抗体呈阳性的基本前提。尽管LAM-B是结核分枝杆菌和麻风分枝杆菌的共同抗原，但由于麻风病在中国的患病率较低，因此该ELISA法在流行病学研究及临床中作为结核病诊断和鉴别诊断的辅助工具的实用性受其影响较小。
