酶联免疫斑点试验对活动性结核病的诊断价值

Value of Enzyme-link Immunospot Assay in Diagnosis of Active Tuberculosis

目的探讨酶联免疫斑点试验(ELISPOT)在活动性结核病中的辅助诊断价值。方法选取活动性结核病患者36例(结核病组)和非结核病患者(对照组)38例,收集受试者外周血单核细胞进行ELISPOT检测,同时对部分受试者进行结核菌素皮肤试验(TST)。结果结核病组中ELISPOT的灵敏度为91.7%(33/36),特异度为81.6%(31/38)。TST的灵敏度为48.1%(13/27),特异度为57.9%(22/38)。同时完成ELISPOT和TST检测的27例结核病患者中,ELISPOT阳性检出率为88.9%(24/27),明显高于TST检出率的48.1%(13/27,P=0.021);对照组中,ELISPOT阳性检出率为18.4%(7/38),明显低于TST检出率的42.1%(16/38,P<0.05)。结论 ELISPOT诊断活动性结核病的准确性较高,可作为结核病的辅助诊断方法。

Objective To explore the auxiliary value of enzyme-link immunospot assay（ELISPOT） for diagnosis of active tuberculosis. Methods Thirty six patients with active tuberculosis（TB group） and 38 patients with non-tuberculosis （control group） were enrolled in the study. The peripheral blood mononuclear cells of all participants were detected by ELISPOT, and some participants also underwent tuberculin skin test （TST） simultaneously. Results The sensitivity, specificity of ELISPOT in TB group were 91.7 % （ 33/36 ） and 81.6 % （ 31/38 ）, respectively, while those of TST were 48.1% （13/27） and 57.9% （22/38） ,respectively. In 27 TB cases who were tested by ELISPOT and TST simultaneously ,the positive rate of ELISPOT was significantly higher than that of TST[88.9% （24/27） vs 48. 1% （13/27） ,P =0. 021 ]. In controls,the positive rate of ELISPOT was significantly lower than that of TST[ 18.4% （7/38） vs 42. 1% （16/38）,P 〈0. 05 ]. Conclusion ELISPOT appears to be a more accurate approach for the auxiliary diagnosis of active tuberculosis.