摘要
为探讨血清特异性结核抗体的辅助诊断价值和加强对小儿肺炎的鉴别诊断，采用酶联免疫吸附试验（ＥＬＩＳＡ）法，对１５７７例肺炎患儿、６８５例健康儿童及１１１例支气管淋巴结结核患儿进行了血清特异性结核抗体检测，用纯蛋白衍生物皮试作对照，肺炎组还作了结核杆菌ＰＣＲ检查。结果表明，结核组患儿的结核抗体阳性８４例（７５．７％），健康组儿童的结核抗体阳性２４例（３．５％），肺炎组的结核抗体阳性２６２例（１６．６％），肺炎组与健康组比较，ｕ＝８．６３，Ｐ＜０．０１。符合儿童结核诊断者３９例，占受检病例的２．５％，占结核抗体阳性病例的１４．９％。ＥＬＩＳＡ法的敏感性为０．７５７、特异性为０．９６５、符合率为０．９３６、阳性预测值为０．７７８、阴性预测值为０．９６１、精确性为０．７２２，９５％可信限为０．６１２～０．８３２之间。提示检测结核抗体有重要辅助诊断价值；肺炎患儿的结核感染率远高于健康组，故应高度警惕，在肺炎患儿中发现结核病患儿，并将其作为重点防治对象。
To evaluate usefulness of detection of serum antibody to Mycobacterium tuberculosis (Mt) in differential diagnosis of respiratory infection in children, the authors measured the specific antibody to Mt by using ELISA method in 1 577 children with pneumonia, 685 healthy children and 111 children with tracheobronchial lymphnode tuberculosis (TB). PPD test was used as a control and the nucleic acid of Mt was determined in pneumonia group with PCR. The results showed that positivity rate of antibody to Mt in TB group and healthy group was 75.7% and 3.5%, respectively. The ELISA showed a sensitivity of 0.757, specificity of 0.965, accordance rate of 0.936, positive predictive value of 0.778, negative predictive value of 0.961, accuracy of 0.722, and 95% confidence interval of 0.612 0.832. In pneumonia group, positivity rate for antibody to Mt was 16.6% (43/262), PPD test was positive in 4.4% and Mt nucleic acid was positive in 6.9%, 39 of the 43 cases were diagnosed as TB. The serum antibody to Mt was positive in significantly highter percentage of pneumonia group as compared to the healthy group ( u=8.63, P<0.01) . The results of this study suggest that detection of serum antibody to Mt is important for diagnosis of TB and that it is important to find out TB among pneumonia patients for better prevention and treatment.
出处
《中华儿科杂志》
CAS
CSCD
北大核心
1997年第8期408-410,共3页
Chinese Journal of Pediatrics
关键词
呼吸道感染
诊断
鉴别诊断
结核杆菌
Antibodies, bacterial Mycobacterium, tuberculosis Respiratory tract infections Diagnosis, differential
