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題 名 | Diagnosis of Tuberculosis Pleurisy by Detection of Specific IgG and IgA Anti-Antigen 60 in Pleural Fluid=藉由偵測肋膜積液中抗A60 IgG及IgA特異抗體來診斷結核性肋膜炎 |
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作 者 | 林旻希; 王鴻昌; 劉慧俐; 朱國安; 盧朝勇; | 書刊名 | 胸腔醫學 |
卷 期 | 16:2 2001.06[民90.06] |
頁 次 | 頁89-94 |
分類號 | 415.43 |
關鍵詞 | A60抗原; 結核性肋膜炎; Antigen 60; IgA; IgG; TB pleurisy; |
語 文 | 英文(English) |
中文摘要 | 利用ELISA偵測IgG及IgA對分枝桿菌A60抗原的抗體來診斷結核性助膜積液。研究的群體包括22個結核性助膜積液的病人。非結核性助膜積液組有23個病人,包括16個惡性助膜積液的病人,4個膿胸/肺炎旁積液,及3個滲出性助膜積液的病人。結核性助膜積液組對分枝桿菌A60抗原的IgG及IgA抗體的血清濃度平均值比非結核性助膜積液組的血清濃度平均值有意義的升高(在抗A60IgG抗體P<0.001,在抗A60 IgA抗體p<0.001)。若以150 IU為切體,IgG的敏感度及特異度分別是63.7%及82.6%。若測量IgA則其敏感度及特異度分別是54.5%及95.6%。22個結核性助膜積液的病人中有19個同時測量了血清IgG的濃度,這些病人的助膜積液與血清的IgG濃度成正相關((r=0.77, p<0.01)。同時,在這些結核性助膜積液的病人中,助膜積液裡的IgG及IgA抗體亦有相關(r=0.59, p<0.01)。籍由同時偵測結核性助膜積液裡的IgG及/或IgA抗體,敏感度及特異度分別是81.8%及82.6%。總之,藉由ELISA偵測抗A60抗原的IgG及IgA抗體是一個迅速且敏感度及特異度均可以接受的鑑吸結核及非結核性助膜積液的方法。 |
英文摘要 | The diagnosis of tuberculous (TB) pleural effusion, in this study, was evaluated by means of an enzyme-linked immunosorbent assay (ELISA) of IgG and IgA antibodies to mycobacterial antigen 60 (A60). The study population consisted of 22 patients with TB pleural effusions. The control group consisted of 23 patients, comprising 16 cases of malignant pleural effusions, 4 cases of empyema/ parapneumonic effusions, and 3 cases of transudative pleural effusions. The mean titers of IgG and IgA against A60 in patients with TB pleural effusions were significcnatly higher than those of the mean values of the control group (p<0.001 in anti-A60 IgG, and p<0.001 in anti-A60 IgA). Using 150 ELISA units (EU) as a cutoff value, the sensitivity and specificity of the IgG measurement were 63.7% and 82.6%, respectively; and using the IgA measurement, these parameters were 54.5% and 95.6%, respectively. serum IgG levels were simultaneously detected in 19 out of 22 patients with tuberculous effusion. A positive correlation was found between the IgG titers of pleural fluids and their corresponding sera (r=0.77, p<0.01). A significant correlation was also found between pleural fluid IgG titers and IgA titers in patients with tuberculous pleural effusions (r=0.59, p<0.01). The sensitivity and specificity of the combined test detecting pleural fluid IgG and IgA levels in patients with TB pleurisy was 81.8% and 82.6%, respectively. in conclusion, the ELISA method, using IgG and IgA against A60, is a quick test with an acceptable sensitivity and specificity for the differentiation of TB and non-TB pleural effusions. |
本系統中英文摘要資訊取自各篇刊載內容。