The Diagnostic Value Of Tuberculosis Antibodies And The Clinical Correlative Research Between Tuberculosis Infection And Mycoplasma Pneumoniae Infection

Object: Study the positive rate of tuberculosis antibodies united detection of protein chip on childhood tuberculosis (pulmonary tuberculosis,extrapulmonary tuberculosis) and latent tuberculosis infection (LTBI), and compare them; compare the sensitivity and specificity of tuberculosis antibodies and PPD skin test, to discuss the diagnostic value of tuberculosis antibodies on childhood tuberculosis. Detect mycoplasma pneumoniae(Mp) antibodies in each group, calculate their positive rate and compare them, to discuss the clinical correlation between tuberculosis infection and Mp infection.Methods: To select the children suspected of tuberculosis infection at out-patient or in hospital from January 2008 to January 2010 in the Children,s Hospital affiliated to Soochow University, all the children had been vaccinated with BCG and detailed records of clinical data. children were divided into groups below: group A: the group of tuberculosis, 41 cases; group A1: the group of pulmonary tuberculosis in group A, 17 cases; group A2: the group of extrapulmonary tuberculosis in group A, 24 cases; group B: the group of LTBI, 53 cases; group C: the group of non-tuberculosis, 85 cases. All groups had PPD skin test, and serums were sampled in two copies. Mycobacterium tuberculosis multiple antigens protein chips were used to detect lipoarabinomannan (LAM), 38KDa protein and 16KDa protein IgG antibodies simultaneously in one serum sample, calculated the positive rate of tuberculosis antibodies and compared them. Calculated the positive rate of each tuberculosis antibody respectively and compared them. Calculated the sensitivity and specificity of tuberculosis antibodies and PPD skin test, and compared them too. Enzyme-Linked Immunosorbent Assay(ELISA) were used to detect Mp-IgM,IgG antibodies in the other serum sample, calculated the positive rate of Mp antibodies and compared them.Results: 1,As to the positive rate of tuberculosis antibodies united detection, group A is significantly higher than group B,group C(P<0.01),group B is higher than group C(P<0.05);group A1 is higher than group A2(P<0.05).2,There is no statistical significant difference in the positive rate of each antibody among group A1,group A2,group B(P>0.05).3,The sensitivity of tuberculosis antibodies united detection is higher than the sensitivity of any single tuberculosis antibody detection(P<0.05).4,There is no statistical significant difference in the sensitivity between tuberculosis antibodies united detection and PPD skin test(P>0.05),but the sensitivity of uniting tuberculosis antibodies with PPD skin test is higher than any single detection(P<0.05); the specificity of tuberculosis antibodies is significantly higher than PPD skin test(P<0.01).5,In group A1 and group A2, there is no statistical significant difference in the positive rate between tuberculosis antibodies united detection and PPD skin tes(tP>0.05). 6,As to the positive rate of Mp antibodies, group A,group B are higher than group C(P<0.05); there is no statistical significant difference in the positive rate of Mp antibodies between group A1 and group A2(P>0.05).Conclusions: 1,The diagnostic value of tuberculosis antibodies united detection to childhood tuberculosis is better than LTBI; its diagnostic value to pulmonary tuberculosis is better than extrapulmonary tuberculosis.2,The positive rate of tuberculosis antibodies united detection is higher than any single tuberculosis antibody detection, so tuberculosis antibodies united detection could increase the positive rate.3,The specificity of tuberculosis antibodies united detection is higher than PPD skin test, and it indicates that tuberculosis antibodies united detection could be an important supplementary diagnostic tool on childhood tuberculosis; its sensitivity is low, but uniting it with PPD skin test could increase the positive rate of tuberculosis. This will reduce the missed diagnosis and it is worth clinical practice.4,As to the positive rate of Mp antibodies, tuberculosis and LTBI are higher than non-tuberculosis; there is no significant difference between pulmonary tuberculosis and extrapulmonary tuberculosis. It indicates that tuberculosis and LTBI are apt to combine with Mp infection, clinicians hence should be on high alert about that.