ELISPOT检测在结核性脑膜炎诊断中的研究

Application of ELISPOT in the diagnosis of tuberculous meningitis

目的利用酶联免疫斑点法(ELISPOT)检测脑脊液中结核抗原特异性的INF-γ分泌细胞数量,研究其在结核性脑膜炎诊断中的价值。方法对104例结核性脑膜炎患者和40例非结核性脑膜炎患者进行脑脊液与血的ELISPOT检测,并与脑脊液抗酸染色涂片、结核菌培养、荧光定量PCR、结核抗体检测进行敏感度和特异性的比较。结果脑脊液ELISPOT检测的敏感度为67.3%、特异性为89.2%,PV+值94.3%优于其他检测方法,差别具有统计学意义(P<0.05),脑脊液ELISPOT检测具有较好的诊断价值(Kappa=0.856,P<0.001)。结论脑脊液ELISPOT检测对结核性脑膜炎诊断的敏感度及特异度高,有望成为快速诊断结核性脑膜炎的一种方法。

Objective To detect antigen-specific INF-γsecreting cells in CSF by ELISPOT assay to deter-mine its clinical value for TBMdiagnosis.Methods The study selected 1 04 patients with tuberculous meningitis and 40 people without tuberculous meningitis to detect their INF-γsecreting cells in CSF and blood by ELISPOT assay. Then the results were compared with AFB staining,Mtb culture,quantitative PCR,and Mtb antibodies.Results The sensitivity of CSF-ELISPOT assay was 92.3%,the specificity was 94.1%,which were higher than other assays （P〈0.05）.The CSF-ELISPOT assay was better than other assay in the diagnosis of TBM （Kappa=0.856,P〈0.001 ）.Conclusion The CSF-ELISPOT assay,with high sensitivity and specificity,will be a rapid diagnostic method for TBM.