摘要
目的探讨酶联免疫斑点干扰素释放试验(ELISPOT)对诊断结核病的临床应用。方法回顾性分析107例结核性疾病患者资料及ELISPOT结果,其中包括活动性结核病组80例,陈旧性结核病组27例;收集60例非结核性疾病患者资料及ELISPOT结果,其中包括免疫损害组30例,健康对照组30例。所有入选对象的标本均用肝素抗凝后,进行ELISPOT的测定,并观察结果。结果 107例结核病患者的阳性结果有90例(84.1%),其中80例活动性结核病的阳性结果有70例(87.5%);27例陈旧性结核病的阳性结果有20例(74.1%)。60例非结核病的阳性结果有10例(16.7%),其中30例免疫损害组的阳性结果有9例(30.0%);30例健康对照组的阳性结果有1例(3.3%)。活动性结核病组与陈旧性结核病组ELISPOT检测灵敏度分别为87.5%(70/80)、74.1%(20/27),差异无统计学意义(P>0.05)。免疫损害组与健康对照组ELISPOT检测的特异度分别为70.0%(21/30)、96.7%(29/30),差异有统计学意义(P<0.05)。结论 ELISPOT对诊断结核病有很高的灵敏度和特异度,尤其在免疫状态正常的人群中诊断结核病的特异度较好。但是,ELISPOT试验并不能很好地区分活动性结核病与陈旧性结核病,对免疫受到损害的人群排查结核病具有明显的局限性,不足以作为该群体排除结核病的依据。
Objective To investigate the clinical application of enzyme-linked immunospot interferon release assay (ELISPOT) in the diagnosis of tuberculosis. Methods A retrospective analysis from September 2015 to November 2016 in Department of Laboratory,the Infectious Diseases Hospital Branch of Anhui Provincial Hospital was performed. 107 cases of tuberculosis in patients with ELISPOT disease data and results,including 80 cases of active tuberculosis group and 27 cases of old tuberculosis group were selected. 60 cases of non-tuberculous disease data and ELISPOT results,including immune damage group in 30 cases,healthy group in 30 cases were collect-ed. All the specimens were tested with enzyme-linked immunospot interferon release assay after anticoagulation with heparin and the re-sults were observed. The data were processed by SPSS 13. 0 software and the difference was statistically significant (P 〈 0. 05). Results One hundred and seven cases of tuberculosis patients in which with positive results in 90 cases was accounting for 84. 1% ,and in which the positive results of active tuberculosis in patients with a total of 70 cases was accounting for 87. 5% . In the case of tuberculosis in old patients with positive results in 20 cases was accounting for 74. 1% ,and in which 60 cases of non-tuberculosis positive results in 10 cases was accounting for 16. 7% ,and in which the results of the group of patients with immune damage in the group of patients with a total of 9 cases was accounting for 30. 0% ,and in which in the healthy control group of 30 cases,there were positive results in 1 ca-ses,accounting for 3. 33% . The sensitivity of ELISPOT detection was 87. 5% (70 / 80) in the active tuberculosis group,74. 1% (20 /27) in the old tuberculosis group. The difference was not statistically significant (P 〉 0. 05). The specificity of ELISPOT detection was 70. 0% (21 / 30) in the immune damage group,96. 7% (29 / 30)in the healthy control group and the difference was statistically signifi-cant (P &lt; 0. 05). Conclusions ELISPOT has a high sensitivity and specificity in the diagnosis of tuberculosis,especially in the normal immune status of the population in the diagnosis of tuberculosis. As a result,the ELISPOT test has no function to distinguish active tu-berculosis from old tuberculosis well,and the damage immune population investigation of tuberculosis has obvious limitations,which not enough to rule out tuberculosis in this population.
出处
《安徽医药》
CAS
2017年第11期2026-2028,共3页
Anhui Medical and Pharmaceutical Journal
关键词
酶联免疫斑点
干扰素释放
结核病
免疫损害
Enzyme-linked immunospot
Interferon release
Tuberculosis
Immune damage