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中国防痨杂志 ›› 2013, Vol. 35 ›› Issue (11): 919-922.

• 论著 • 上一篇    下一篇

不同抗原全血ELISA检测技术对活动性肺结核的辅助诊断价值研究

杨新婷 梁清涛 杨扬 李琦 陈效友   

  1. 101149  首都医科大学附属北京胸科医院结核三科  北京市结核病胸部肿瘤研究所
  • 收稿日期:2013-09-12 出版日期:2013-11-10 发布日期:2013-11-03
  • 通信作者: 陈效友 E-mail:chenxy1998@hotmail.com
  • 基金资助:

    首都医学发展科研基金(20093147)

Study on the value of diagnosis for active pulmonary tuberculosis with the blood ELISA stimulated by three antigens

YANG Xin-ting, LIANG Qing-tao, YANG Yang, LI Qi, CHEN Xiao-you   

  1. The 3rd Department of Tuberculosis, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis & Thoracic Tumor Research Institute,Beijing 101149,China
  • Received:2013-09-12 Online:2013-11-10 Published:2013-11-03
  • Contact: CHEN Xiao-you E-mail:chenxy1998@hotmail.com

摘要: 目的 探讨克隆表达的抗原PPD、早期分泌抗原靶6(ESAT-6)/培养滤液蛋白10(CFP-10)融合蛋白(简写为E/C)和ESAT-6的全血干扰素释放试验对活动性肺结核的辅助诊断价值。  方法 选取活动性结核组96例和对照组91例共计187例,抽取清晨空腹肝素钠抗凝外周静脉血5 ml,分别给以抗原PPD、E/C和EAST-6刺激,通过ELISA的方法检测抗原刺激后血浆中IFN-γ的数值。  结果 在活动性肺结核组中3种抗原刺激后IFN-γ含量的中位数分别为ESAT-6[96(41~379)pg/ml]、E/C[3180(1192~7231)pg/ml]、PPD[4348(1230~9026)pg/ml];明显高于对照组中IFN-γ含量ESAT-6[10(4~52)]、E/C[210(49~523)]、PPD[1800(70~3021)pg/ml],U值分别为1190.5、2405和1309.5,P值均<0.01;ESAT-6、E/C和PPD的全血ELISA敏感度分别为78.1%(75/96)、87.5%(84/96) 和85.4%(82/96),特异度分别为76.9%(70/91)、83.5%(76/91)和65.9%(60/91)。  结论 融合蛋白ESAT-6/CFP-10对活动性结核病具有一定的辅助诊断价值。

关键词: 结核, 肺/诊断, 重组融合蛋白质类, 酶联免疫吸附测定, &, gamma, 干扰素释放试验

Abstract: Objective  To evaluate the value of diagnosis for active pulmonary tuberculosis with blood interferon gamma release assay stimulated by three antigens of PPD, ESAT-6/CFP-10 fusion protein(E/C) and ESAT-6.  Methods  187 participants including patients with active pulmonary tuberculosis and control were enrolled. 5 ml morning fasting venous heparinazed blood were taken from all participants and stimulated by purified protein derivative(PPD), early secretory antigenic target 6(ESAT-6) and E/C. The production of IFN-γ was measured by ELISA after incubated for 16-22 hours. Results  The production of IFN-γ stimulated by ESAT-6, E/C and PPD in active pulmonary tuberculosis was 96(41-379), 3180(1192-7231) and 4348(1230-9026) pg/ml, respectively. It was much higher than that in control (ESAT-6:10(4-52)、E/C: 210(49-523)、PPD: 1800(70-3021),U=1190.5、2405和1309.5,P<0.01). The sensitivity and specificity of ESAT-6, E/C and PPD were 78.1%(75/96) vs 76.9%(70/91)、87.5%(84/96) vs 83.5%(76/91) and 85.4%(82/96) vs 65.9%(60/91), respectively. Conclusion  The ESAT-6/CFP-10 fusion protein could be a very useful supplementary tool for the diagnosis of active pulmonary tuberculosis.

Key words: Tuberculosis, pulmonary/diagnosis, Recombinant fusion proteins, Enzyme-linked immunosorbent assay, Interferon-gamma release tests