酶联免疫斑点法对AIDS患者感染结核分枝杆菌的诊断价值

The diagnostic value of enzyme-linked immunospot assay in AIDS patients with Mycobacterium tuberculosis infection

目的探讨酶联免疫斑点(ELISPOT)法对获得性免疫缺陷综合征(AIDS)患者感染结核分枝杆菌的诊断价值。方法选取该院AIDS合并结核分枝杆菌感染的42例住院患者作为观察组。另外,选取未患结核病的同期呼吸系统疾病住院患者60例做为对照组,两组均采用ELISPOT法、结核抗体(TBAb)法及结核分枝杆菌素皮试试验(TST)分别进行检测,比较3种方法的灵敏度、特异度及准确度。结果对于结核分枝杆菌感染诊断,ELISPOT法的灵敏度、特异度、准确度分别为92.9%、93.3%、93.1%,TBAb法分别为54.8%、71.7%及64.7%,TST法为47.6%、53.3%及51.0%。3种检测方法的灵敏度、特异度及准确度比较,差异均有统计学意义(P<0.05)。两两比较,ELISPOT法的灵敏度、特异度及准确度均高于TBAb法及TST法(P<0.05);TBAb法与TST法比较,差异无统计学意义(P>0.05)。结论 ELISPOT对AIDS患者感染结核分枝杆菌具有较高的诊断价值。

Objective To explore the value of enzyme‐linked immunospot（ELISPOT ） assay in the diagnosis of acquired immu‐nodeficiency syndrome（AIDS） patients with Mycobacterium tuberculosis infection .Methods 42 hospitalized AIDS patients with Mycobacterium tuberculosis infection and 60 non‐tuberculosis hospitalized patients with diseases of respiratory system in the same period were recruited as observation group and control group ,respectively .ELISPOT assay ,tuberculosis antibody（TBAb） test and tuberculin skin test（TST） were performed for all the patients ,respectively .The sensitivity ,specificity and accuracy of the 3 meth‐ods were comparatively analyzed .Results The sensitivity ,specificity and accuracy of ELISPOT were 92 .9% ,93 .3% and 93 .1% . These of TBAb were 54 .8% ,71 .7% and 64 .7% ,and of TST were 47 .6% ,53 .3% and 51 .0% ,respectively .There were significant differences among three methods in sensitivity ,specificity and accuracy（P〈0 .05） .The sensitivity ,specificity and accuracy of ELIS‐POT were the highest in the 3 methods（P〈0 .05） .There were no significant differences between TBAb test and TST in sensitivi‐ty ,specificity and accuracy（P〉0 .05） .Conclusion ELISPOT assay has relatively high diagnostic value in AIDS patients with My‐cobacterium tuberculosis infection .