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目的探讨免疫荧光染色法检测脑脊液细胞中结核早期分泌性靶抗原6(ESAT-6)对结核性脑膜炎诊断的价值。方法收集36例确诊结核性脑膜炎患者的脑脊液为病例组,45例非结核性脑膜炎患者脑脊液为对照组。用双盲法对2组脑脊液细胞进行ESAT-6免疫荧光染色,统计分析灵敏度和特异度等。结果病例组ESAT-6存在于中性粒细胞、单核细胞及淋巴细胞中,对照组脑脊液细胞中无ESAT-6表达。灵敏度为88.89%、特异度为93.33%;阳性预测值为91.43%、阴性预测值为91.30%;阳性似然比为13.33、阴性似然比为0.12;Youden指数为82.22%,ROC曲线下面积为0.94。结论免疫荧光染色检测脑脊液细胞中ESAT-6的灵敏度及特异度均较高,是结核性脑膜炎诊断的有效方法。
Objective To investigate the diagnostic value of early secreted target antigen 6 (ESAT-6) in cerebrospinal fluid (CSF) in the diagnosis of tuberculous meningitis by immunofluorescence staining. Methods Cerebrospinal fluid was collected from 36 patients diagnosed as tuberculous meningitis and 45 patients with non-tuberculous meningitis as control group. ESAT-6 immunofluorescence staining was performed on two groups of cerebrospinal fluid cells by double-blind method, and the sensitivity and specificity were statistically analyzed. Results ESAT-6 was found in neutrophils, monocytes and lymphocytes in the case group, but not in the control group. The positive predictive value was 91.43%, the negative predictive value was 91.30%, the positive likelihood ratio was 13.33, the negative likelihood ratio was 0.12, the Youden index was 82.22%, the area under the ROC curve was 0.94. Conclusion The sensitivity and specificity of ESAT-6 detected by immunofluorescence staining in cerebrospinal fluid are high, which is an effective method for the diagnosis of tuberculous meningitis.