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目的:探讨3种结核分枝杆菌保守抗原Ag85A、Ag85B和HspX抗原特异性细胞免疫反应对结核性胸膜炎的辅助诊断价值。方法:收集我院收治的胸腔积液患者30例,根据胸水性质,分为结核性胸膜炎组20例,非结核性胸膜炎组10例。收集胸水样本,分离胸水样本中细胞成分。原核表达、纯化并鉴定结核分枝杆菌Ag85A、Ag85B、HspX蛋白。用Ag85A、Ag85B及HspX蛋白分别刺激2组患者的胸水细胞成分,通过ELISA技术检测IFN-γ表达水平并进行组间比较。结果:Ag85A蛋白刺激后,非结核性胸膜炎组IFN-γ为(15.50±2.41)ng/L,结核性胸膜炎组IFN-γ为(1 775.00±362.86)ng/L;Ag85B蛋白刺激后,非结核性胸膜炎组IFN-γ为(14.89±2.30)ng/L,结核性胸膜炎组IFN-γ为(2 442.50±418.94)ng/L;HspX蛋白刺激后,非结核性胸膜炎组IFN-γ为(14.20±2.30)ng/L,结核性胸膜炎组IFN-γ为(3 570.00±496.41)ng/L;两组比较均P<0.01。结核性胸膜炎组中,不同患者对不同抗原刺激所产生的IFN-γ水平有一定差别。结论:结核性胸膜炎患者胸水中的细胞成分经Ag85A、Ag85B及HspX蛋白刺激后,IFN-γ水平均不同程度明显升高,该方法对结核性胸膜炎有一定的辅助诊断价值。
Objective: To investigate the diagnostic value of three kinds of Mycobacterium tuberculosis conserved antigens Ag85A, Ag85B and HspX antigen-specific cellular immune response to tuberculous pleurisy. Methods: Thirty patients with pleural effusion admitted to our hospital were collected. According to the nature of pleural effusion, they were divided into 20 cases of tuberculous pleurisy group and 10 cases of non-tuberculous pleurisy group. Collect pleural fluid samples and separate the cellular components in pleural fluid samples. Prokaryotic expression, purification and identification of Mycobacterium tuberculosis Ag85A, Ag85B, HspX protein. The components of pleural effusion in two groups of patients were stimulated with Ag85A, Ag85B and HspX respectively. The expression of IFN-γ was detected by ELISA and compared between groups. Results: After stimulated with Ag85A, the IFN-γ in non-tuberculous pleurisy group was (15.50 ± 2.41) ng / L and that in tuberculous pleurisy group was (1775.00 ± 362.86) ng / L; The levels of IFN-γ in sex pleurisy group were (14.89 ± 2.30) ng / L, those in tuberculous pleurisy group were (4442 ± 418.94) ng / L, and those in non-tuberculous pleurisy group were 14.20 ± 2.30) ng / L, IFN-γ in tuberculous pleurisy group was (3 570.00 ± 496.41) ng / L, P <0.01. Tuberculous pleurisy group, different patients on different antigen-stimulated IFN-γ levels produced by a certain difference. CONCLUSIONS: The levels of IFN-γ in pleural fluid of patients with tuberculous pleurisy were significantly increased after stimulated by Ag85A, Ag85B and HspX protein. This method may be of value in the diagnosis of tuberculous pleurisy.