为评价以脂阿拉伯甘露糖(LAM)和重组38kD蛋白为混合抗原在结核病血清学诊断中的应用价值，在128例活动性结核病患者（活动性肺结核107例，肺外结核21例）﹑51例潜伏性结核感染者和68例健康对照者血清中检测抗LAM和38kD的IgG抗体（LAM-38kD-IgG）。结果显示，LAM-38kD-IgG检测总的敏感性为46.88%，特异性为98.53%，阳性预测值为98.36%，阴性预测值为49.63%。其中肺结核组敏感性为46.73%，肺外结核为47.62%（P>0.05）；初治组为45.54%，复治组为51.85%（P>0.05）。涂阳肺结核组敏感性为52.54%，高于涂阴组（39.58%），但差异无统计学意义（P>0.05）。 LAM-38kD-IgG检测在实验对照组中的特异性为98.53%。与结核菌素试验（TST）比较，其特异性远高于TST的41.46%（P<0.01）。LAM-38kD-IgG水平与病情变化有一定的相关性。本研究证实应用LAM和38kD混合抗原的ELISA诊断技术在诊断活动性结核方面具有中等的敏感性和极高的特异性及阳性预测值，不仅可与结核病的其它诊断方法联用以提高诊断的准确性，而且特别适用细菌学检查阴性结核病和肺外结核病。

The objective of the current study is to evaluate sera lipoarabinomannan-38kD-IgG (LAM-38kD-IgG) test in the serological diagnosis of tuberculosis(TB). 128 active tuberculosis patients (107 pulmonary TB, 21 extrapulmonary TB )，51 with latent TB infection and 68 healthy people were enrolled and diagnosed by clinic, bacteriology and X-ray examination. All specimens were studied for LAM-38kD-IgG by using Enzyme-Linked Immunosorbent Assay(ELISA). The results demonstrated that the total sensitivity and specificity of LAM-38kD-IgG test of active tuberculosis patients were 46.88% and 98.53%. The positive predict value and the negative predict value of LAM-38kD-IgG test were 98.36% and 49.63% respectively. The sensitivity of LAM-38kD-IgG test in the diagnosis of pulmonary tuberculosis and extra-pulmonary tuberculosis were 46.73% and 47.62% (P>0.05) respectively; the sensitivities in the patients with smear-positive and smear-negative pulmonary tuberculosis were 52.54% and 39.58% (P>0.05) respectively. The specificity of LAM-38kD-IgG test was higher than tuberculin test (TST) (41.46%). It was concluded that LAM-38kD-IgG test has a very good specificity and an acceptable sensitivity and positive predictive value. It is thought that it could be used in combination with other methods to increase diagnostic accuracy, especially for culture-negative and extrapulmonary tuberculosis cases, which are difficult to diagnose.