Radhakrishnan V V, Sehgal S, Mathai A
Department of Pathology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, India.
J Med Microbiol. 1990 Dec;33(4):223-6. doi: 10.1099/00222615-33-4-223.
A retrospective study was done to correlate culture of Mycobacterium tuberculosis and detection of mycobacterial antigen in cerebrospinal fluid (CSF) by an inhibition enzyme-linked immunosorbent assay (ELISA). M. tuberculosis was cultured from CSF of 14 out of 70 patients with a clinical diagnosis of tuberculous meningitis (TBM). Mycobacterial antigens were demonstrated in CSF specimens by inhibition ELISA in all 14 culture-positive patients with antigen concentrations of 14.5-295 ng/ml (mean 158.8 ng/ml). Thus there was positive correlation between the detection of mycobacterial antigen and isolation of M. tuberculosis. Based on this observation, 56 CSF specimens from culture-negative patients with clinically diagnosed TBM were examined for mycobacterial antigen and the data were compared with those from culture positive patients. ELISA gave positive results in 38 specimens, with antigen levels of 12.5-280 ng/ml (mean 152.6 ng/ml). In 70 CSF specimens from patients with non-tuberculous neurological disease (control group), ELISA results were negative. Thus, detection of mycobacterial antigen in CSF specimens by inhibition ELISA had a specificity of 100% and a sensitivity of 67.8% for the diagnosis of TBM and is of potential value in the laboratory diagnosis of TBM.
开展了一项回顾性研究，以关联结核分枝杆菌培养结果与通过抑制酶联免疫吸附测定（ELISA）检测脑脊液（CSF）中的分枝杆菌抗原。在70例临床诊断为结核性脑膜炎（TBM）的患者中，有14例患者的脑脊液培养出结核分枝杆菌。在所有14例培养阳性患者的脑脊液标本中，通过抑制ELISA检测到分枝杆菌抗原，抗原浓度为14.5 - 295 ng/ml（平均158.8 ng/ml）。因此，分枝杆菌抗原检测与结核分枝杆菌分离之间存在正相关。基于这一观察结果，对56例临床诊断为TBM但培养阴性患者的脑脊液标本进行了分枝杆菌抗原检测，并将数据与培养阳性患者的数据进行比较。ELISA在38份标本中给出阳性结果，抗原水平为12.5 - 280 ng/ml（平均152.6 ng/ml）。在70例患有非结核性神经系统疾病患者的脑脊液标本（对照组）中，ELISA结果为阴性。因此，通过抑制ELISA检测脑脊液标本中的分枝杆菌抗原对TBM诊断的特异性为100%，敏感性为67.8%，在TBM的实验室诊断中具有潜在价值。
