特异性抗体和特异性免疫复合物的检测对结核病的诊断意义

The Diagnostic Significance of Detecting Specific Antibody and Specific Immune Complex

关键词:  结核  抗-PPD IgG抗体  ELISA

Key words:  tuberculosis  anti-PPD IgG antibody  ELISA

摘要:

以ELISA检测108例活动性肺结核、39例稳定期肺结核、30例肿瘤、101例非结核性肺部疾病患者及202例正常人血清的抗结核菌纯蛋白衍生物(PPD)IgG抗体(简称抗-PPD)和循环免疫复合物(CIC)中的抗-PPDIgG抗体(简称CIC-PPD)。结果表明,活动性肺结核患者的抗-PPD和CIC-PPD水平明显高于正常人和各疾病组患者的水平(P<0.001),但与其病变范围无关。单一测定活动性肺结核患者的抗-PPD,敏感性为85.2%,特异性为98.5%;测定CIC-PPD,敏感性为86.1%.特异性96.9%。以两者任一项阳性作为诊断活动性肺结核的标准,则敏感性为93.5%。此外,对11例活动性肺结核患者的动态观察表明,随着治疗天数的增加和临床症状的改善,患者的抗-PPD和CIC-PPD水平会逐渐降低,前者于治疗后第20~24周降至正常水平,后者则于治疗后第12~16周降至正常值。研究结果提示测定患者的抗-PPD和CIC-PPD的水平,可用于结核病诊断,对结核病的疗效判定亦有帮助。

Abstract:

Anti-PPD IgG antibody (anti-PPD) and anti-PPD in circulatory immune complex (CIC-PPD) were detected by ELISA in 108 cases of active tuberculosis, 39 cases of inactive tuberculosis, 30 cases of tumour, 101 cases of nontuberculosis lung diseases and 202 cases of health persons as controlThe results showed that the levels of anti-PPD and CIC-PPD in active tuberculosis patients were significantly higher than those in health persons and other diseaese patients (P<0.001), but no relation with the range of tuberculosis' focus. Anti-PPD estimated alone had a sensitivity of 85.2% and a specificity of 98.5%, and CIC-PPD, a sensitivity of 86.1% and a specificity of 96.9%. If taking the positive alternative of anti-PPD and CIC-PPD as the standard of diagnosing active tubgrculosis, then the sensitivity would be 93.5%. In addition, according to the dynamic observation of 11 cases of activetuberculosis patients showed that anti-PPD and CIC -PPD would gradually reduce wiht the increases of treatment-days and improvement of the symptoms of patients. Anti-PPD would be normal in 20to 24 weeks after treatment, and CIC-PPD, in 12 to 16 weeks. Thus, it,s useful for either diagnosis of tuberculosis or determining' curative effect by detecting anti-PPD and CIC-PPD.