细胞免疫学和血清学两种方法检测结核分枝杆菌纯蛋白衍生物强阳性者的结果差异

Difference between Determination Results of Strong Purified Protein Derivative of Tuberculin-positive Cases by Cellular Immunological and Serological Methods

目的比较细胞免疫学和血清学两种方法检测结核分枝杆菌纯蛋白衍生物(Purified protein derivative of tuberculin,PPD)皮试强阳性者的结果差异,探讨适于结核杆菌(Mycobacterium tuberculosis,MTB)潜伏感染者的筛查方法。方法经志愿者前臂皮内注射PPD 0.1 ml(含5个结核菌素单位),72 h后,选择硬结平均直径≥15 mm的PPD强阳性者,按硬结直径大小分成3个等级,采集静脉血,分离外周血单个核细胞(Peripheral blood mononuclear cell,PBMC)和血清,分别应用T-SPOT.TB和OMEGA结核诊断试剂盒进行细胞免疫学和血清学检测,并比较检测结果的差异。结果 PPD皮试强阳性不同等级人群中,细胞免疫学和血清学检测结果差异均无统计学意义(P﹥0.05);但在所有PPD皮试强阳性者中,两种方法的检测结果差异有统计学意义(P﹤0.01)。结论 细胞免疫学检测方法具有良好的特异性和灵敏度,更适用于MTB潜伏感染者的筛查。

Objective To compare the difference between determination results of strong purified protein derivative of tuberculin（PPD）-positive cases by cellular immunological and serological methods,and investigate the methods for screening of latent Mycobacterium tuberculosis（MTB） infection.Methods Volunteers were injected s.c.with 0.1 ml of PPD（containing five tuberculin units） in forearm,of whom strong PPD-positive ones with mean diameter of indurations of not less than 15 mm were selected 72 h later,and divided into three grades according to the sizes of indurations.Venous blood samples were collected,from which peripheral blood mononuclear cell（PBMC） and sera were separated for cellular immunological and serological tests by using T-SPOT.TB and OMEGA kits respectively,and the results were compared.Results Neither cellular immunological nor serological determination results of strong PPD-positive cases of various grades showed significant difference（P 0.05）.However,in all the cases,the determination results by two methods showed significant difference（P 0.01）.Conclusion Cellular immunological method showed high specificity and sensitivity,and was more suitable for screening of latent MTB infection.