结核分枝杆菌IFN-γ酶联免疫斑点检测在结核诊断中的应用

Clinical Application of IFN-γ ELISPOT in Diagnosis of Pulmonary Tuberculosis

目的采用结核分枝杆菌特异性IFN-γ酶联免疫斑点(简称Elispot)检测技术对不同的人群进行检测,评价其在结核诊断中的应用情况。方法290例结核病人(结核组),其中肺结核221例中痰抗酸染色(AFB)阳性者89例,AFB阴性者132例;同时选取133例健康志愿者为健康组。采用自行建立的Elispot技术对2组外周血结核菌特异性IFN-γ水平进行检测;对11例结核病人和10例健康者同时采用T-SPOT.TB试剂盒进行平行检测。结果Elispot反应阳性率结核组为83.79%,显著高于健康组的16.54%(P<0.001);AFB(+)肺结核病人阳性率为89.89%,AFB(—)肺结核病人阳性率为81.06%,两者差异无显著性意义(P>0.05)。T-SPOT.TB与Elispot平行检测阳性率比较,差异无显著性意义(P>0.05)。结论结核菌特异性IFN-γElispot检测技术在结核诊断中显示出较好的特异性和敏感性,可作为临床结核病诊断的辅助手段。

Objective To investigate clinical application of IFN-γ ELISPOT in diagnosis of pulmonary tuberculosis. Methods Two hundred ninety patients with tuberculosis（221 cases of them were pulmonary tuberculosis,and 89 cases of pulmonary tuberculosis were AFB-positive and 132 cases were AFB-negative）and 113 healthy controls were enrolled in our test. The antigen specific IFN-γ response of two groups,were evaluated by an in-house Elispot assay. The performance of Elispot and commercial T-SPOT. TB were compared in parallel in 11 patients with pulmonary tuberculosis and 10 healthy controls. Results Positive IFN-γ responses were detected in 83.79% of patients with pulmonary tuberculosis and 16.54% of healthy controls using in-house ELISPOT assay. Among the patients, those of sputum-positive have higher positive rate （89.89%） of IFN-γ responses than others of sputum-negative（81.06%）（P〉0.05）. The comparative study indicated that there was no statistical difference between our in-house Elispot and T-SPOT. TB assay （χ2=0.5,P=0. 4795）. Conclusions Antigen-specific IFN-γ ELISPOT assay could be useful for the diagnosis of pulmonary tuberculosis.