本文選題：CFP-10 + ESAT-6�。� 參考：《寧波大學(xué)》2013年碩士論文

【摘要】：結(jié)核病一直以來嚴(yán)重危害著人們的健康，全世界大約有30%的人口感染了結(jié)核，其中發(fā)展中國家更甚。在肺外結(jié)核中，結(jié)核性腦膜炎(Tubercular meningitis,TBM)最為致命，結(jié)核性胸膜炎（Tuberculous pleurisy,TBP)則較為常見。TBM的高死亡率導(dǎo)致患者痊愈后往往留下嚴(yán)重的神經(jīng)系統(tǒng)功能缺損。由于細(xì)菌培養(yǎng)較為困難及費(fèi)時、現(xiàn)在仍然依據(jù)臨床癥狀，胸部影像學(xué)表現(xiàn)，實(shí)驗(yàn)室檢查等綜合表現(xiàn)來進(jìn)行綜合診斷。結(jié)核桿菌特異性分泌蛋白早期分泌靶6000蛋白（ESAT-6）和培養(yǎng)濾液蛋白10（CFP-10）的出現(xiàn)給診斷結(jié)核帶來新的契機(jī)，通過應(yīng)用酶聯(lián)免疫吸附法（enzymelinked immunosorbent assay，ELISA）方法來檢測特定部位的特異性蛋白的含量能夠提高對結(jié)核的診斷率。目的：應(yīng)用ELISA法檢測腦脊液及胸水中ESAT-6和CFP-10的含量，以早期輔助診斷結(jié)核性腦、胸膜炎。方法：將收集的29例陽性病例（結(jié)核性腦膜炎及胸膜炎的病人）和30例對照病例應(yīng)用ELISA檢測其腦脊液或胸水ESAT-6和CFP-10蛋白，并與用聚丙烯酰胺凝膠塊濃縮腦脊液或胸水后檢測ESAT-6和CFP-10蛋白濃度,再與未濃縮前的結(jié)果進(jìn)行比較。結(jié)果：濃縮前后病例組與對照組的CFP-10和ESAT-6蛋白的陽性率有顯著差異，P0.01，濃縮前的標(biāo)本：CFP-10的靈敏度為62.1%(95%置信區(qū)間[CI],39-76)，特異度為86.7%(95%CI,69-96)。ESAT-6的靈敏度為68.9%(95%CI,49-85)，特異度為90%(95%CI,73-98)。兩蛋白聯(lián)合診斷的靈敏度為79.3%(95%CI,60-92)，特異度為96.7%（95%CI,83-100)。濃縮后的標(biāo)本： CFP-10的靈敏度為68.9%(95%CI,49-85)，特異度為86.7%(95%CI,69-96)。 ESAT-6的靈敏度為72.4%(95%CI,53-87)，特異度為90%(95%CI,73-98)，兩蛋白聯(lián)合診斷的靈敏度為89.6%(95%CI,63-98)，特異度為96.7%（95%CI,83-100)。病例組CFP-10和ESAT-6蛋白之間的靈敏度及特異度比較無顯著差異，P0.05。濃縮前兩蛋白聯(lián)合診斷的靈敏度較單個蛋白CFP-10之間有差異，P0.05,較ESAT-6蛋白無差異，，P0.05。濃縮后兩蛋白聯(lián)合診斷的靈敏度較單個蛋白無顯著差異,濃縮前后兩蛋白聯(lián)合診斷的特異度較ESAT-6和CFP-10蛋白均無差異，P0.05。結(jié)論: ESAT-6和CFP-10ELISA檢測結(jié)核具有較高的靈敏度和特異度，且兩個蛋白聯(lián)合診斷的靈敏度較單個蛋白(CFP-10)的高，另此法較為簡便和廉價，適合用于結(jié)核性腦膜炎和胸膜炎的早期輔助診斷。
[Abstract]:Tuberculosis has been a serious threat to people's health. About 30 percent of the world's population is infected with tuberculosis, especially in developing countries. In extrapulmonary tuberculosis, tuberculous meningitis TBMis is the most fatal, and tuberculous pleurisy TBPPs are more common. The high mortality rate of. TBM often leads to severe neurological impairment after recovery. Because bacteria culture is difficult and time-consuming, comprehensive diagnosis is still based on clinical symptoms, chest imaging findings, laboratory examination and so on. The emergence of mycobacterium tuberculosis specific secretory protein ESAT-6 and culture filtrate protein 10CFP-10 brings a new opportunity for the diagnosis of tuberculosis. Enzyme linked immunosorbent assay (Elisa) was used to detect the specific protein content in specific parts of tuberculosis by enzyme linked immunosorbent assaysa (Elisa) method, which could improve the diagnosis rate of tuberculosis. Objective: to detect the contents of ESAT-6 and CFP-10 in cerebrospinal fluid and pleural effusion by ELISA method in order to diagnose tuberculous meningitis and pleurisy in early stage. Methods: ELISA was used to detect ESAT-6 and CFP-10 protein in cerebrospinal fluid or pleurisy of 29 positive cases (tuberculous meningitis and pleurisy) and 30 control cases. The results were compared with those before concentration of ESAT-6 and CFP-10 protein in CSF or pleural effusion. Results: the positive rates of CFP-10 and ESAT-6 protein were significantly different between the two groups before and after concentration. The sensitivity of the sample before and after concentration was 62.1% 95% confidence interval [CI] 39-76, the specificity was 86.7% 95CIN 69-960.The sensitivity of ESAT-6 was 68.9% 95CII 49-85, and the specificity was 90,95CI73-980.Results: the positive rate of CFP-10 and ESAT-6 protein was significantly higher than that of control group before and after concentration. The sensitivity of the sample before and after concentration was 62.1% and 95% confidence interval [CI], and the specificity was 68.9% and 73-98%, respectively. The sensitivity of the combined diagnosis of the two proteins is 79.3% and the specificity is 96.795 / 95 CI83-100. The sensitivity of CFP-10 was 68.9% and the specificity was 86.7%. The sensitivity of ESAT-6 is 72. 4% and 95%. The specificity is 90. 95%. The sensitivity of the combined diagnosis of the two proteins is 89. 6 and 95. The sensitivity of the two proteins is 89. 6 and 95. The specificity is 96. 795. The specificity is 83-100. There was no significant difference in sensitivity and specificity between CFP-10 and ESAT-6 protein. The sensitivity of the two proteins in the combined diagnosis was higher than that in the single protein CFP-10 (P 0.05), but no difference was found between the two proteins (P 0.05) than that of the ESAT-6 protein (P 0.05). There was no significant difference in the sensitivity of the combined diagnosis of the two proteins compared with that of the single protein, and the specificity of the combined diagnosis of the two proteins before and after concentration was not different from that of the ESAT-6 and CFP-10 proteins (P 0.05). Conclusion: ESAT-6 and CFP-10ELISA have high sensitivity and specificity in the detection of tuberculosis, and the sensitivity of the combined diagnosis of the two proteins is higher than that of single protein CFP-10. It is suitable for early diagnosis of tuberculous meningitis and pleurisy.
【學(xué)位授予單位】：寧波大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2013
【分類號】：R521.7;R529.3

【參考文獻(xiàn)】

相關(guān)期刊論文 前9條

1 周霞;葉燕青;;利用rCFP-10/ESAT-6融合蛋白刺激γ-IFN體外釋放測定替代結(jié)素皮試檢出結(jié)核感染的可行性[J];氨基酸和生物資源;2008年03期

2 廖瓊;鄧建軍;鄧思燕;萬朝敏;;兒童結(jié)核性腦膜炎近期預(yù)后的影響因素[J];中國當(dāng)代兒科雜志;2012年05期

3 張玉花;李國保;王偉;史慧敏;胡建平;張國龍;劉新;;ESAT-6檢測的臨床應(yīng)用研究[J];醫(yī)藥論壇雜志;2008年23期

4 黃星;曾麗;;結(jié)核性腦膜炎240例臨床分析[J];臨床薈萃;2007年11期

5 何俊瑛;劉士甫;朱艷霞;郭偉賓;洪坤;李美杰;鄒月麗;;腦脊液單核細(xì)胞內(nèi)ESAT-6檢測對結(jié)核性腦膜炎的診斷意義[J];腦與神經(jīng)疾病雜志;2010年03期

6 路慧麗;俞眉;韓偉;;趨化因子CXCL9/Mig的研究進(jìn)展[J];中國生物工程雜志;2006年10期

7 婁培安;章輝;李玲;劉加彬;王曉婷;周艷秋;趙廣法;朱蔭昌;;重組結(jié)核桿菌分泌融合蛋白活性鑒定及應(yīng)用[J];中國公共衛(wèi)生;2006年05期

8 吳雪瓊;;結(jié)核分枝桿菌保護(hù)性抗原的研究進(jìn)展[J];中華結(jié)核和呼吸雜志;2006年05期

9 吳曉牧;劉麗娟;許志強(qiáng);胡國柱;曹文鋒;黃剛;胡凡;張昆南;;早期診斷結(jié)核性腦膜炎的新方法:檢測濃縮腦脊液中CFP-10和ESAT-6[J];中國免疫學(xué)雜志;2012年04期

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