T-SPOT.TB在快速诊断结核分枝杆菌感染中的价值

Value of T-SPOT. TB Kit for Rapid Diagnosis of Mycobacterium Tuberculosis Infection

目的探讨T-SPOT.TB(结构感染T细胞斑点实验)酶联免疫斑点技术(enzyme-linked immunospot assay,ELISPOT)在临床快速诊断结核感染中的应用价值。方法应用T-SPOT.TB试剂盒检测肺结核组198例,非结核感染组201例患者外周血T细胞对结核分枝杆菌菌种特异性分泌蛋白,早期分泌靶抗原6(ESAT-6)和培养分泌蛋白10(CFP-10)的免疫反应。对肺结核及其他疾病患者在入院时做痰涂片、痰培养、痰快速培养(BACTEC960)、痰结核分枝杆菌DNA(MtbDNA)和血清结核抗体(Mtb-AB)检查。结果 198例肺结核组中,175例(88.4%)T-SPOT.TB检测阳性;201例非结核感染组中,97例(48.3%)T-SPOT.TB检测阳性(χ2=74.01,P值<0.01)。在肺结核组T-SPOT.TB的阳性率为89.4%明显高于结核菌涂片8.1%,结核菌培养28.0%,Mtb-DNA 12.0%和Mtb-AB 31.6%,(χ2=202.00,χ2=103.68,χ2=60.86,χ2=66.78,P值均<0.01)。结论 T-SPOT.TB在检测结核感染、辅助结核病诊断治疗优于其他检测方法具有很高的应用价值。

Objective To investigate the T - SPOT. TB （ enzyme - linked immunospot assay, ELISPOT） in rapid diagnosis of clini- cal tuberculosis infection. Methods The peripheral blood T cells from TB infection group （containing 198 TB patients） ;non -TB in- fection group （containing 201 non - TB patients） were detected by T - SPOT. TB kit. Mycobacterium tuberculosis strain specific secre- tory proteins early secretory antigenic target of 6 （ESAT-6） and cultivation of secretory protein 10 （CFP- 10） immune response. Rapid culture for tuberculosis and other diseases were sputum smear, sputum culture, sputum culture at the time of admission （ BACTEC960）, Mtb - DNA and serum tuberculosis antibody （ Mtb - AB） examination at the same time. Results In TB infection group,88.4% were positive by T SPOT - TB detection. In non - TB infection group ,201 cases of non - tuberculosis infection group, 97 cases （ 48.3% ） tested positive for T - SPOT. TB （X2 = 74.01 ,P 〈 0.01 ）. The positive rate of pulmonary tuberculosis group blood T- SPOT. TB 89.4% was significantly higher than that of 8. 1% Mycobacterium tuberculosis, Mycobacterium tuberculosis culture 28%, Mtb - DNA 12.0% and Mtb - AB 31.6%, （χ2 = 202.00 ,χ2 = 103.68 ,χ2 = 60. 86 ,χ2= 66.78, P 〈 0.01 ）. Conclusion T - SPOT. TB in detecting tuberculosis infection and tuberculosis diagnosis and treatment aided than other detection method has high appli- cation value.