活化特异结核感染T淋巴细胞斑点法在获得性免疫缺陷综合征潜伏结核感染诊断中的应用

Application of tuberculosis infection T cell spot test in detecting latent tuberculosis infection in acquired immune deficiency syndrome patients

目的:了解上海市公共卫生临床中心潜伏性结核感染(LTBI)比例,评价活化特异结核感染T淋巴细胞斑点试验(TSPOT.TB)筛查人类免疫缺陷病毒(HIV)感染者/获得性免疫缺陷综合征(AIDS)患者、结核病患者、其他疾病就诊患者LTBI的可行性。方法:上海市公共卫生临床中心自2012年7月至2015年12月以来收治7 482例患者,其中HIV感染者/AIDS患者1 837例、结核病患者1 689例、其他疾病就诊患者3 956例,分别进行TSPOT.TB,筛查可能的LTBI者,并采用结核分枝杆菌涂片实验和X射线胸部透视(胸透)进一步证实。结果:HIV感染者/AIDS患者、结核病患者和其他疾病就诊患者中TSPOT.TB阳性者分别为301例(16.39%)、928例(54.94%)和1 509例(38.14%),并且结核分枝杆菌涂片实验结果均为阴性,而且经胸透结果证实。结论:活化特异TSPOT.TB筛查HIV感染者/AIDS患者、结核病患者、其他疾病就诊患者LTBI的方法可行,并且对HIV感染者/AIDS患者开展LTBI的检测非常重要。

Objective To understand the ratio of latent tuberculosis infection（LTBI） in Shanghai Public Health Clinical Center and to define the feasibility of using TB infection T cell spot test（TSPOT. TB） to detect LTBI in patients with acquired immune deficiency syndrome（AIDS）, TB and other diseases. Methods Altogether 1 837 patients with HIV/AIDS, 1 689 patients with TB and 3 956 patients with other diseases in Shanghai Public Health Clinical Center from July2012 to December 2015 were examined by TSPOT. TB test to screen LTBI. Furthermore, TB acid-fast stain smear and chest X-rays were used to confirm the results. Results The positive rates of TSPOT. TB were 16.39%（301/1 837）, 54.94%（928/1 689） and 38.14%（1 509/3 956） respectively in HIV/AIDS patients, TB patients, and patients with other diseases.Mycobacterium TB acid-fast stain smear was negative and confirmed by chest X-ray. Conclusions TSPOT. TB assay is feasible for screening LTBI in patients with HIV/AIDS, TB and other diseases, and screening of LTBI in HIV/AIDS patients is very important.