AKCİĞER TÜBERKÜLOZU TANISINDA 38kDa ANTİJENİNE ÖZGÜL IgG’NİN ÖLÇÜLMESİNİN ÖNEMİ VE DEĞERİ

Öz

Tüberkülozun (TB) erken ve hızlı tanısı hala önemli bir problemdir. Bu nedenle klasik tanı yöntemlerinin dışında spesifik, hızlı, pratik ve güvenilir yeni tanı yöntemleri araştırılmaktadır. Bu çalışmada, aktif TB hastalarında Enzim Linked Immun Assay (ELISA) ile mikobakterilerin 38kDa antijenine karşı oluşan IgG antikor cevabının ve PPD testi ile bu antikor cevabı arasındaki ilişkinin araştırılması planlandı. Çalışmaya 486 aktif akciğer TB’lu, 23 inaktif tüberkülozlu, 100 TB dışı akciğer hastalığı olan ve 48 sağlıklı olgu alındı. Bu hastaların serumlarında mikobakterilerin 38 kDa antijenine karşı oluşan IgG antikoruna bakıldı. PPD pozitifliği ile ilişkisi değerlendirildi. Çalışmamızda; 486 aktif akciğer TB’lu hastada IgG (+)’liği %53 (257 olgu) idi. Aktif akciğer TB’lu hastalarda IgG (+)’liğinin sensitivitesi %53 ve spesifitesi %99 bulundu. Aktif akciğer TB hastaları ile inaktif akciğer TB’lu, TB dışı akciğer hastaları ve sağlıklı kontrol grupları karşılaştırıldığında; aktif akciğer tüberkülozlu grubun IgG (+)’liğinde diğer gruplara göre anlamlı artış gösterilmiştir (p=0,0002 ve p=0,00001). PPD testi pozitif olanlarla negatif olanların IgG düzeyleri karşılaştırıldığında IgG düzeyi PPD testi pozitif olanlarda anlamlı olarak yüksekti) [1.065±1.06, 0.587±0.66 (p=0,003)] ve aradaki fark istatistiksel olarak anlamlı bulundu . Çalışma sonuçlarında, aktif akciğer tüberkülozlu olgularla inaktif formların ayırımında serum IgG (+) ölçümünün tanıya büyük katkı sağladığı düşünülmüştür. Ayrıca 38 kDa antijenine dayalı ELISA yöntemi; kolay temin edilebilen; hızlı, spesifik ve ucuz bir yöntem olduğundan epidemiyolojik araştırmalarda ve taramalarda da kullanılabileceği sonucuna varılmıştır. Dr.Ayşegül ŞENTÜRK Dr. Hatice Kutbay ÖZÇELİK Dr.Arman POLUMAN

Anahtar Kelimeler

• Aktif akciğer tüberkülozu
• IgG pozitifliği
• sensitivite
• 38 kDa antijeni

VALUE OF THE DETECTİON OF IgG LEVELS TO 38kDa ANTIGEN IN THE DIAGNOSIS OF PULMONARY TUBERCULOSIS

Öz

Early and rapid diagnosis of tuberculosis is still an important problem. Therefore, outside the classical diagnostic methods, specific, rapid, practical and reliable new diagnostic methods are being investigated. In this study, IgG antibody response against 38kDa antigen of mycobacterium and correlation between PPD test and IgG antibody response was investigated in patients with active tuberculosis, by ELISA. 486 patients with active pulmonary tuberculosis, 23 patients with inactive tuberculosis, 100 patients with non-tuberculosis lung disease and 48 healthy subjects were enrolled into the study. IgG antibodies against mycobacterium 38kDa antigen were measured in the serum of these patients. And the correlation of the resuts to the PPD positiveness was evaluated. In our study, IgG seropositivity was 53% (257 cases) in 486 patients with active pulmonary tuberculosis. Sensitivity and specificity of IgG positivity in active pulmonary tuberculosis patients were found 53% and 99%, respectively. Between active pulmonary tuberculosis patients and inactive pulmonary tuberculosis patients, non-tuberculosis lung disease patients and healthy control groups, IgG positivity was significantly higher in favor of the first group. (p=0,0002 and p=0,00001). IgG levels were significantly higher in the PPD positive patients than the PPD negative patients [1 065±1.06, 0.587+0.66 (p=0,003)] Therefore, we think the test will greatly help in the differential diagnosis of active forms and inactive forms. Furthermore, because 38 kDa antigen ELISA method is a specific and cheap method it can be usufull especially in the epidemiological studies .

Anahtar Kelimeler

• Active pulmonary tuberculosis
• IgG antibodies
• sensitivity
• 38kDa antigen.

Kaynakça

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