酶联免疫斑点技术辅助诊断小儿结核性脑膜炎的临床意义

Analysis of the utility of enzyme-linked immunospot assay in children with tuberculous meningitis

目的：探讨酶联免疫斑点技术（ELISPOT）在小儿结核性脑膜炎诊断中的应用价值。方法：收集0～14岁疑似结核性脑膜炎患儿共17例进行ELISPOT检测，对最终确诊病例进行分析，并与头颅CT／MRI检查、结核菌纯蛋白衍生物试验（PPD）试验、脑脊液检查、结核抗体检查、胸片结果相对比。结果：在最终确诊的13例结核性脑膜炎中，头颅CT／MRI、PPD、脑脊液、结核抗体、胸片在入院5d内的检查阳性率分别为30．8％、30．8％、23．1％、12．5％、30．8％，而ELISPOT阳性率为76．9％，显著高于其它辅助检查方法（P〈0．05）。结论：ELISPOT检硷灵敏、快速，对于小儿结核性脑膜炎有早期诊断价值。

Objective： To analyze the diagnostic utility of enzyme-linked immunospot assay in children with tuberculous meningitis. Methods： Total of seventeen children aged from 0414 years who were assessed for suspected tuberculous meningitis were enrolled in this study and were detected by enzyme-linked immunospot assay （ELISPOT）, the result was compared with the final clinical diagnosis as well as the results of CT/MRI, PPD test, cerebrospinal fluid test,tuberculosis antibody test, and chest X-ray test. Results： In 13 cases who were finally diagnosed of tuberculous meningitis, the positive rate of CT/MRI, PPD test, cerebrospinal fluid test,tuberculosis antibody test,and chest X-ray test in the early 5 days of hospitalization are 30.8%, 30.8%, 23. 1%, 12. 5% and 30.8% respectively, while the positive rate of ELISPOT was 76.9%, significantly higher than those in other diagnostic methods （P 〈0. 05）. Conclusion. Enzymelinked immunospot assay has better early diagnostic value than other traditional diagnostic methods. It can be used in the early diagnosis of tuberculous meningitis in children.