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目的评价脑脊液抗酸杆菌(AFB)、抗阿拉伯糖甘露糖脂IgG抗体(LAM-IgG)和腺苷脱氨酶(ADA)联合试验诊断小儿结核性脑膜炎(结脑)的价值。方法于1996—2005年采用承德医学院附属医院的脑脊液检测标本(其中结脑组62例、非结脑组38例),应用离心甩片法检测AFB、斑点免疫金渗滤试验法检测LAM-IgG、酶动力学终点法检测ADA。结果AFB、LAM-IgG和ADA的阳性率分别为64.5%、51.6%和59.7%,AFB+LAM-IgG诊断结脑的特异性为100%、敏感性为67.7%,AFB+LAM-IgG+ADA的阳性率为71.0%。病情进展,ADA呈升高趋势;病情好转,ADA呈下降趋势。结论在诊断结脑方面,AFB+LAM-IgG联合试验的应用价值明显高于经典方法;在动态了解病情方面,ADA有较高的应用价值。三者联合应用可提高对结脑诊断和评价的价值。
Objective To evaluate the value of AFB, LAM-IgG and ADA in the diagnosis of tuberculous meningitis in children (tuberculous meningitis). Methods Cerebrospinal fluid samples from the affiliated hospital of Chengde Medical College were collected from 1996 to 2005 (62 cases in the tuberculous group and 38 cases in the non-tuberculous group). AFB was detected by centrifugation rejection and the expression of LAM- IgG, enzyme kinetic endpoint detection of ADA. Results The positive rates of AFB, LAM-IgG and ADA were 64.5%, 51.6% and 59.7%, respectively. The specificity of AFB + LAM-IgG was 100%, the sensitivity was 67.7% The positive rate was 71.0%. The progression of the disease, ADA showed an upward trend; condition improved, ADA showed a downward trend. Conclusions In the diagnosis of tuberculous meningitis, the application value of AFB + LAM-IgG combination test is obviously higher than that of classical methods. ADA has a high value in dynamically understanding the disease. The combination of the three can improve the diagnosis and evaluation of tuberculosis.