脂阿拉伯甘露聚糖诊断结核性脑膜炎的评价

中国防痨杂志 ›› 2005, Vol. 27 ›› Issue (5): 316-318.

脂阿拉伯甘露聚糖诊断结核性脑膜炎的评价

李永刚¹；杨昆胜²；晋华文²；陈涛²；

1.深圳武警医院；深圳 518029；2.云南省昆明医学院第一附属医院；昆明 650032；

出版日期:2005-05-10 发布日期:2005-11-03

The clinical evaluation of lipoarabinomannan for diagnosis of tuberculous meningitis

Li Yanggang¹,Yang Kunsheng,Jin Huawen,et,al1.

Department of Neurology,The Armed Forces Police Hospital in Shen Zhen,Shenzhen 518029,China

Online:2005-05-10 Published:2005-11-03

摘要/Abstract

摘要： 目的　评价分枝杆菌脂阿拉伯甘露聚糖(LAM)的诊断价值并给出受试者工作特征曲线(ROC)。方法应用斑点金免疫渗滤技术平行检测结核性脑膜炎(TBM)及非结核性神经精神系统疾病血清(Serum)和脑脊液(CSF)中抗LAM抗体。Serum稀释25倍,CSF分别按1、2、4、8、16、32倍稀释。进行抗LAM抗体检测。结果 Serum敏感性(Sencitivity,Se)为96.9%,特异性(Specificity,Sp)58.3%。CSF在稀释倍数为12、4、、8、163、2时Se分别为93.6%,90.6%,56.3%,37.5%,12.5%,3.1%,Sp分别为83.3%、95.8%、95.8%、100%、100%、100%。最佳截切值(Cut-Off)为2倍稀释。统计分析表明,CSF在2倍稀释时其Se与Serum无显著性差异,但Sp有显著性差异。结论应用斑点金免疫渗滤技术检测抗LAM抗体诊断价值较高。

关键词: 结核,脑膜/诊断, 脂阿拉伯甘露聚糖, 脑脊液

Abstract: Objective To evaluate the clinical value of lipoarabinomannan for diagnosis of tuberculous meningitis and to determine the ROC.Method The detection of anti-LAM-antibodies made by dot-immunolgold filtration assay in sera and cerebrospinal fuid(CSF) from patients with tuberculous meningitis and non-tuberculosis.The sera was diluted by 25 times and the CSF by 1,2,4,8,16,32 times.Results The sensitivity and specificity in serum was 96.9% and 58.3% respectively.The two indexes in CSF with the dilution of 1,2,4,8,16,32 times were 93.8%,90.6%,56.3%,37.5%,12.5%,3.1% and 83.3%,95.8%,95.8%, 100%,100%,100%.The best cut-off value was in CSF with dilution 2 times on which the specificity was significant difference compared with that of sera,but there was no significant different on sensitivity.Conclusion The detection of anti-LAM-antibodies in CSF made by dot-immunolgold assay is a useful tool.

Key words: Tuberculosis,Meningeal/Diagnosis, Lipoarabinomannan, Cerebrospinal fluid

李永刚,杨昆胜,晋华文,陈涛,. 脂阿拉伯甘露聚糖诊断结核性脑膜炎的评价[J]. 中国防痨杂志, 2005, 27(5): 316-318.

Li Yanggang¹,Yang Kunsheng,Jin Huawen,et,al1.. The clinical evaluation of lipoarabinomannan for diagnosis of tuberculous meningitis[J]. Chinese Journal of Antituberculosis, 2005, 27(5): 316-318.

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