T细胞斑点试验联合隐球菌乳胶凝集试验对肺结核合并肺隐球菌病诊断的初步研究

Enzyme-linked immunospot assay combined with serum latex agglutination test for diagnosis of pulmonary tuberculosis and concomitant pulmonary cryptococcosis

目的评价结核分枝杆菌感染T细胞斑点试验(TB ELISPOT)和乳胶凝集试验(LA)联合检测对肺结核合并肺隐球菌病的诊断价值。方法选择2006年3月—2008年9月我中心呼吸科收治的疑诊肺结核合并肺隐球菌病患者76例,均同时作TB ELISPOT、LA检测和肺组织病理检查。结果76例患者中,经病原学和病理学确诊为肺隐球菌病15例,肺结核22例,其中肺结核合并肺隐球菌病8例。经检测LA的灵敏度和特异度均为100%,TB ELISPOT的灵敏度和特异度分别为91%和94.4%,8例肺结核合并肺隐球菌病患者LA和TB ELISPOT均为阳性。结论LA和TB ELISPOT联合检测对肺结核合并肺隐球菌病具有诊断价值。

Objective To evaluate the value of enzyme-linked immunospot assay （TB ELISPOT） combined with serum latex agglutination test （LA） for diagnosis of pulmonary tuberculosis plus pulmonary cryptococcosis. Methods Serum and biopsy specimens of 76 patients, who were suspected of pulmonary tuberculosis and/or pulmonary eryptococcosis based on elinieal and imaging features, were collected from March 2006 to September 2008 in Shanghai Public Health Clinical Center. TB ELISPOT assay, LA and histopathologieal examination were performed in all the patients. Results Histopathological and pathogenic examination confirmed pulmonary cryptococcosis in 15 cases and pulmonary tuberculosis in 22 cases, pulmonary tuberculosis plus pulmonary cryptococcosis in 8 cases. The sensitivity and specificity of TB ELISPOT were 91% and 94.4%. The sensitivity and specificity of LA were both 100%. TB ELISPOT assay and LA test were both positive in the 8 cases of pulmonary tuberculosis plus pulmonary cryptococeosis. Conclusions The value of enzyme-linked immunospot assay combined with serum latex agglutination test is high for diagnosis of pulmonary tuberculosis plus pulmonary cryptococcosis.