Charpin D, Herbault H, Gevaudan M J, Saadjian M, de Micco P, Arnaud A, Vervloet D, Charpin J
Département des Maladies Respiratoires, Hôpital Sainte-Marguerite, Marseille, France.
Am Rev Respir Dis. 1990 Aug;142(2):380-4. doi: 10.1164/ajrccm/142.2.380.
This investigation was undertaken to assess the effectiveness of an enzyme-linked immunosorbent assay (ELISA) using A60 antigen in ascertaining diagnosis in hospitalized patients suspected to have pulmonary tuberculosis (TB) but with negative sputum stains. Cultures were performed to confirm active or inactive disease. IgG and IgM antibody activity was determined by adding a 1:100 dilution of serum to plates coated with A60 antigen. After addition of peroxidase-conjugated antihuman IgG or IgM and color development, optical density (OD) was determined. A total of 83 patients was studied, taking into account their current disease status and prior history. Using as a cutoff value the mean value +/- 2 SD measured in the negative culture, no TB history group, that is, OD = 0.50 for IgG measurements and 0.43 for IgM measurements, the sensitivity, specificity, and positive predictive value of IgG measurements were equal to 48, 71, and 50%, respectively. Using IgM measurements, these parameters were equal to 76, 98, and 95%, respectively. Combining the results of IgG and IgM measurements, sensitivity, specificity, and positive predictive value were equal to 68, 100, and 100%, respectively. Thus, the ELISA described here can greatly facilitate the diagnosis of TB in patients with negative smears.
本研究旨在评估使用A60抗原的酶联免疫吸附测定（ELISA）在确诊疑似患有肺结核（TB）但痰涂片阴性的住院患者中的有效性。进行培养以确认疾病处于活动期或非活动期。通过将1:100稀释的血清加入包被有A60抗原的平板中来测定IgG和IgM抗体活性。加入过氧化物酶标记的抗人IgG或IgM并显色后，测定光密度（OD）。共研究了83例患者，考虑了他们当前的疾病状况和既往病史。以在阴性培养、无TB病史组中测得的平均值±2个标准差作为临界值，即IgG测定的OD = 0.50，IgM测定的OD = 0.43，IgG测定的敏感性、特异性和阳性预测值分别为48%、71%和50%。使用IgM测定时，这些参数分别为76%、98%和95%。将IgG和IgM测定结果相结合，敏感性、特异性和阳性预测值分别为68%、100%和100%。因此，本文所述的ELISA可极大地促进涂片阴性患者的TB诊断。
