【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5ml,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。更多还原

【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-10fusion protein(E/C)and ESAT-6.Methods 187participants including patients with active pulmonary tuberculosis and control were enrolled.5ml 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-γwas measured by ELISA after incubated for 16-22hours.Results The production of IFN-γstimulated 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)vs76.9%(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-10fusion protein could be a very useful supplementary tool for the diagnosis of active pulmonary tuberculosis.更多还原