Chang F Y, Young T, Hsu G J, Peng M Y, Yang C H, Chou M Y
Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, R.O.C.
Zhonghua Min Guo Wei Sheng Wu Ji Mian Yi Xue Za Zhi. 1993 Nov;26(4):151-9.
The serodiagnosis of tuberculosis (TB) by using an enzyme-linked immunosorbent assay (ELISA) to detect IgG against mycobacterial antigen 60 (A60) was evaluated. Forty-three controls (10 healthy adults, 19 patients with non-tuberculous pulmonary diseases and 14 patients with non-pulmonary infectious diseases) and 63 patients with TB in different disease activity (50 patients with active TB and 13 patients with old pulmonary TB) were studied. When a cut-off value of 200 units was selected, the results obtained with controls were: 100% negative in IgG titers in healthy adults and patients with non-pulmonary infectious diseases, 89% negative in IgG titers in patients with non-tuberculous pulmonary diseases. The overall "false positive" rate was 5% in the control groups. The percentage of serologically positive cases of active TB was: 82% in smear-positive, 67% in smear-negative/culture-positive and 38% in culture-negative. Of the 13 patients with calcified pulmonary TB, four had a positive serological response (31%). Four out of eight patients with active TB showed an elevation in IgG titer 1 to 3 months after diagnosis and anti-TB chemotherapy. The positive and negative predictive values of the test may provide valuable information according to the prevalence of TB in different populations. When the TB prevalence is high, a positive IgG ELISA test may support the diagnosis of active TB.
评估了采用酶联免疫吸附测定（ELISA）检测抗结核分枝杆菌抗原60（A60）的IgG进行结核病（TB）血清学诊断的情况。研究了43名对照者（10名健康成年人、19名非结核性肺病患者和14名非肺部感染性疾病患者）以及63名处于不同疾病活动期的结核病患者（50名活动性结核病患者和13名陈旧性肺结核病患者）。当选择200单位的临界值时，对照者的检测结果如下：健康成年人和非肺部感染性疾病患者的IgG滴度100%为阴性，非结核性肺病患者的IgG滴度89%为阴性。对照组的总体“假阳性”率为5%。活动性结核病血清学阳性病例的百分比为：涂片阳性者中82%，涂片阴性/培养阳性者中67%，培养阴性者中38%。13例钙化性肺结核病患者中，4例血清学反应呈阳性（31%）。8例活动性结核病患者中有4例在诊断和抗结核化疗后1至3个月IgG滴度升高。根据不同人群中结核病的患病率，该检测的阳性和阴性预测值可能提供有价值的信息。当结核病患病率较高时，IgG ELISA检测呈阳性可能支持活动性结核病的诊断。
