摘要
目的探讨结核分枝杆菌感染T细胞斑点试验（spot test of T cells infected with Mycobacterium tuberculosis,TSPOT.TB）评分在多系统结核感染诊断中的应用价值。方法回顾性纳入2013年10月至2014年9月在郑州大学第一附属医院住院并确诊为结核感染的530例患者,所有患者均应用T-SPOT.TB试剂盒检测。分别将外周血中经6 k D早期分泌靶抗原（early secretory antigenic target 6,ESAT-6）和10 k D培养滤过蛋白（culture filtrate protein 10,CFP-10）刺激后T细胞斑点形成数记为其A值、B值。根据病变侵及范围分为单系统结核感染组和多系统结核感染组,分析两组间阳性检出率及两组A值、B值的差异。结果 T-SPOT.TB诊断结核感染的总敏感性为87.7%（465/530）。多系统结核感染组的阳性检出率94.1%（143/152）高于单系统结核感染组的阳性检出率85.1%（322/378）。多系统感染组的A值（202.32±4.57）/10~6PBMCs及B值（207.20±4.98）/10~6PBMCs均显著高于单系统感染组的A值（35.51±2.38）/10~6PBMCs及B值（38.48±1.91）/10~6PBMCs,差异均具有统计学意义（t_A=5.33;t_B=4.48;P〈0.001）。结论 T-SPOT.TB在诊断单系统及多系统结核感染中具有较高的敏感性,其值越高,提示多系统结核感染的可能性越大。
Objective To evaluate the diagnostic value of T- SPOT. TB scores in multi- system tuberculosis. Methods A retrospective analysis of 530 tuberculosis patients hospitalized from October of 2013 to September of 2014 was performed. All patients were tested with T- SPOT. TB assay. The T- SPOT. TB assay yielded values A and B,which represented the number of T cells that were stimulated by the antigens for early secreting antigen target 6（ ESAT- 6） or culture filtrate protein- 10 peptide（ CFP- 10）. The patients were divided into single- system and multiple- system group according to the extent of the disease.Independent- samples t tests were used to compare the values A and B between the two groups. Results In 530 patients included in this study,465 tested positive with a sensitivity of 87. 7%. In multi- system groups,the positive rate（ 94. 1%,143 /152）was higher than that（ 85. 1%,322 /378） in single- system groups. The mean A and B values in the multi- system group[（ 202. 32 ± 4. 57） /10~6 PBMCs and（ 207. 20 ± 4. 98） /10~6PBMCs],were significantly greater than those in the single- system group [（ 35. 51 ± 2. 38） /10~6 PBMCs and（ 38. 48 ± 1. 91） /10~6PBMCs]（ t_A= 5. 33,t_B= 4. 48,P〈0. 001）. Conclusion T-SPOT. TB score could play an important role in identifying single- system and multi- system tuberculosis infections. Higher score indicates a greater likelihood of multiple- system tuberculosis infection.
出处
《河南医学研究》
CAS
2016年第1期37-39,共3页
Henan Medical Research
