血清结核抗体检测在类鼻疽患者中的临床意义
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摘要
目的探讨血清16KDa抗体、38KDa抗体和LAM抗体是否存在于类鼻疽患者血清中及其临床意义。方法选择2016年9月—2018年3月在海南医学院第二附属医院微生物室分离鉴定出类鼻疽伯克霍尔德菌的23例患者作为类鼻疽组,另选择同期体检的23例健康体检者作为对照组,用结核蛋白芯片法检测类鼻疽患者及健康体检者血清中的16KDa抗体、38KDa抗体和LAM抗体,应用Fisher确切概率计算法对结果进行分析。结果健康组人群血清中没有检出16KDa抗体、38KDa抗体和LAM抗体。类鼻疽组患者血清中没有检出16KDa抗体,血清38KDa抗体阳性率为60.87%(14/23),LAM抗体阳性率为69.57%(16/23),38KDa抗体阳性率和LAM抗体阳性率差异无统计学意义(P>0.05),两者的阳性率均高于16KDa抗体阳性率,差异有统计学意义(P<0.01),结果模式以38KDa抗体和LAM抗体阳性组合模式为主。与对照组比较,类鼻疽患者血清38KDa抗体阳性率和LAM抗体阳性率均较高,差异有统计学意义(P<0.01)。结论应用生物蛋白芯片技术检测类鼻疽患者血清中结核分枝杆菌的38KDa抗体、LAM抗体可能为临床类鼻疽诊断提供新的依据。
Objective To detect whether there are antibodies to 16 k Da protein, 38 k Da protein and lipoarabinomannan(LAM) in the serum of melioidosis patients, and to explore the clinical value of it. Methods From September 2016 to March2018, a total of 23 patients who were identified by clinical microbiology chamber for Burkholderia pseudomallei infections,were selected as the melioidosis group. At the same period, 23 cases of healthy people were selected as the control group.Tuberculosis protein chip was used for determining the levels of serum 16 k Da antibody and 38 k Da antibody and LAMantibody of the two groups, and the results were analyzed by Fisher's exact test. Results There weren't 16 k Da antibody and38 k Da antibody and LAM antibody in serum of healthy people. For the melioidosis patients, there wasn't 16 k Da antibody inserum, and 38 k Da antibody and LAM antibody of positive rate were 60.86%(14/23), 69.57%(16/23), respectively. There wasno difference in the level of serum 38 k Da antibody and LAM antibody in melioidosis patients(P>0.05), and the positive rate ofthe two antibodies were higher than 16 k Da antibody(P<0.01). Compared with healthy people, the positive rate of serum 38 k Da antibody and serum LAM antibody in melioidosis patients were significantly higher than that of the healthy people(P<0.01). Conclusions Determining the level of serum 38 k Da antibody and LAM antibody by tuberculosis protein chip may beused as the new indicators for the diagnosis of melioidosis.
Objective To detect whether there are antibodies to 16 k Da protein, 38 k Da protein and lipoarabinomannan(LAM) in the serum of melioidosis patients, and to explore the clinical value of it. Methods From September 2016 to March2018, a total of 23 patients who were identified by clinical microbiology chamber for Burkholderia pseudomallei infections,were selected as the melioidosis group. At the same period, 23 cases of healthy people were selected as the control group.Tuberculosis protein chip was used for determining the levels of serum 16 k Da antibody and 38 k Da antibody and LAMantibody of the two groups, and the results were analyzed by Fisher's exact test. Results There weren't 16 k Da antibody and38 k Da antibody and LAM antibody in serum of healthy people. For the melioidosis patients, there wasn't 16 k Da antibody inserum, and 38 k Da antibody and LAM antibody of positive rate were 60.86%(14/23), 69.57%(16/23), respectively. There wasno difference in the level of serum 38 k Da antibody and LAM antibody in melioidosis patients(P>0.05), and the positive rate ofthe two antibodies were higher than 16 k Da antibody(P<0.01). Compared with healthy people, the positive rate of serum 38 k Da antibody and serum LAM antibody in melioidosis patients were significantly higher than that of the healthy people(P<0.01). Conclusions Determining the level of serum 38 k Da antibody and LAM antibody by tuberculosis protein chip may beused as the new indicators for the diagnosis of melioidosis.
引文
[1]刘倩颖,王心静,林明贵.血清结核杆菌抗体检测在结核病的临床意义[J].中国实验诊断学,2014,18(7):1105-1107.
[2]孙娜.结核杆菌抗体检测在结核病诊断中的应用价值[J].中国医药指南,2016,14(15):40-41.
[3]王艳玲.血清结核杆菌抗体检测对结核病诊断的意义[J].医疗装备,2016,29(23):133-135.
[4]陈国英.血清结核抗体与痰涂片诊断结核病的价值及准确性比较[J].中外医学研究,2016,14(11):49-50.
[5]钱东林.蛋白芯片检测结核分枝杆菌对肺结核病的临床诊断价值[J].标记免疫分析与临床,2013,20(5):352-353.
[6]张仁卿,邓长国.结核蛋白芯片检测对结核病的诊断价值[J].四川医学,2016,37(10):1140-1143.
[7]何英武.结核抗体蛋白芯片法对老年肺结核的诊断价值研究[J].临床误诊误诊,2014,27(6):47-49.
[8]蔡新霞,王容侠,宋晓佳,等.血清结核分枝杆菌Ig G抗体检测对结核病的诊断价值[J].中国热带医学,2015,15(2):236-237.
[9]黄正谷,付晓,钟敏,等.三种结核抗体检测方法在肺结核辅助诊断中的价值[J].检验医学与临床,2014,11(14):1949-1953.
[10]何启军,姚敏,吴秀继,等.免疫法测结核抗体与痰涂片镜检法的比较[J].中国热带医学,2017,17(4):427-428.
[11]FANG Y,CHEN H,LI Y L,et al.Melioidosis in Hainan,China:a restrospective study[J].Trans R Soc Trop Med Hyg,2015,109(10):636-642.
[12]靳亚莉,张振国,乐宏元,等.寻常性银宵病患者血清中抗两种分枝杆菌LAM抗原抗体的检测[J].中国皮肤性病学杂志,2016,30(11):1104-1106.
[13]孟苏凯,吴振萍,张玉华,等.血清结核抗体检测在结核病临床诊断中的价值[J].中国卫生检验杂志,2015,25(22):3858-3860.
[2]孙娜.结核杆菌抗体检测在结核病诊断中的应用价值[J].中国医药指南,2016,14(15):40-41.
[3]王艳玲.血清结核杆菌抗体检测对结核病诊断的意义[J].医疗装备,2016,29(23):133-135.
[4]陈国英.血清结核抗体与痰涂片诊断结核病的价值及准确性比较[J].中外医学研究,2016,14(11):49-50.
[5]钱东林.蛋白芯片检测结核分枝杆菌对肺结核病的临床诊断价值[J].标记免疫分析与临床,2013,20(5):352-353.
[6]张仁卿,邓长国.结核蛋白芯片检测对结核病的诊断价值[J].四川医学,2016,37(10):1140-1143.
[7]何英武.结核抗体蛋白芯片法对老年肺结核的诊断价值研究[J].临床误诊误诊,2014,27(6):47-49.
[8]蔡新霞,王容侠,宋晓佳,等.血清结核分枝杆菌Ig G抗体检测对结核病的诊断价值[J].中国热带医学,2015,15(2):236-237.
[9]黄正谷,付晓,钟敏,等.三种结核抗体检测方法在肺结核辅助诊断中的价值[J].检验医学与临床,2014,11(14):1949-1953.
[10]何启军,姚敏,吴秀继,等.免疫法测结核抗体与痰涂片镜检法的比较[J].中国热带医学,2017,17(4):427-428.
[11]FANG Y,CHEN H,LI Y L,et al.Melioidosis in Hainan,China:a restrospective study[J].Trans R Soc Trop Med Hyg,2015,109(10):636-642.
[12]靳亚莉,张振国,乐宏元,等.寻常性银宵病患者血清中抗两种分枝杆菌LAM抗原抗体的检测[J].中国皮肤性病学杂志,2016,30(11):1104-1106.
[13]孟苏凯,吴振萍,张玉华,等.血清结核抗体检测在结核病临床诊断中的价值[J].中国卫生检验杂志,2015,25(22):3858-3860.