痰涂阳性肺结核患者密切接触者结核菌感染情况调查

Investigation of contacts of persons with smear-positive pulmonary tuberculosis patients

目的应用早期建立的结核分枝杆菌特异性IFN-γ酶联免疫斑点(Elispot)检测技术,以及结核菌素皮肤试验评价痰涂阳性肺结核患者密切接触者中结核菌的感染情况。方法采用Elispot技术检测1 242例痰涂阳性肺结核患者的密切接触者进行外周血结核菌特异性IFN-γ水平,同时平行进行PPD皮试。结果Elispot在密切接触者以及接触者中家属,朋友的阳性率分别是30%,34.25%和22.1%,PPD相应的结果是13.2%,15.57%和8.9%;两者阳性率比较差异有统计学意义(P<0.01)。Elisopt阳性率在不同年龄组均高于PPD,结果差异均有统计学意义。在47例确诊肺结核患者(发病率达3.78%)中,其中Elispot阳性34例(72.34%),PPD强阳性12例(25.53%);两者阳性率有统计学意义(P<0.01)。结论与PPD比较利用Elispot诊断结核潜伏感染有较高辅助诊断价值。利用Elispot监测结核密切接触者,有利于早期发现结核病人。

Objective To survey the infectious status of Mycobacterium tuberculosis in close contacts with smearpositive tuberculosis patients through the early establishment of mycobacterium tuberculosis specificity IFN-γenzyme-linked immune spot（Elispot） detection technology and tuberculin skin test（TST）.Methods The IFN-γlevels of 1 242 samples of close contacts with smear-positive tuberculosis patients were detected by using Elispot and PPD skin tests in parallel at the same time.Results The positive rates of Elispot in close contacts as well as their family members and friends were 30%,34.25% and 22.1%,respectively,where the corresponding results of PPD were 13.2%,15.57% and 8.9%;The positive rates of both were statistically significant.Elisopt positive rates in different age groups were higher than PPD,and the results were statistically significant（P0.01）.In 47 confirmed TB patients（with incidence of 3.78%）,there were 34 cases of positive Elispot（72.34%） and 12 cases of PPD strong positive（25.53%）;The positive rates of both were statistically significant（P0.01）.Conclusions Compared with PPD,Elispot is of higher value in diagnosis of latent tuberculosis infection and thus it is suitable for early detection of tuberculosis cases.