结核特异性抗原刺激产生的IL-2在诊断活动性结核中的应用

Application of IL⁃2 stimulated by tuberculosis⁃specific antigen in the diagnosis of active tu⁃berculosis

目的单中心研究结核特异性抗原刺激产生的IL-2诊断活动性结核的诊断性能。方法连续收集2022年12月至2023年2月来潍坊市第二人民医院就诊的疑似肺结核患者的血液标本,将血液标本进行T-SPOT.TB试验,并同时应用酶联免疫吸附试验(ELISA)检测患者血液中淋巴细胞经特异性抗原刺激产生的IL-2的水平。结果2022年12月至2023年2月,共有199名疑似肺结核症状的患者纳入本研究,其中138例被临床诊断为活动性结核,58例为临床确诊病例。T-SPOT.TB诊断活动性结核的敏感度为89.13%(123/138),特异度为65.57%(40/61),阳性预测值为85.42%(123/144),阴性预测值为72.72%(40/55);IL-2诊断活动性结核病敏感度和特异度分别为84.1%(116/138)、88.50%(54/61),阳性预测值为94.30%(116/123),阴性预测值为71.05%(54/76)。IL-2与T-SPOT.TB诊断活动性结核的特异度分别为88.50%(54/61)、65.57%(40/61),差异有统计学意义(χ^(2)=9.085,P<0.05)。结论结核特异性抗原刺激产生的IL-2在诊断活动性结核时,具有较高的灵敏度和特异度,是一种潜在的区分活动性结核与结核潜伏感染的重要标志物。

Objective To investigate the diagnostic performance of IL-2 stimulated by tuberculo-sis specific antigen in the diagnosis of active tuberculosis.Methods Blood samples were continuously col-lected from suspected pulmonary tuberculosis patients who visited the Second People's Hospital of Weifang City from December 2022 to February 2023.These blood samples underwent the T-SPOT.TB test,and the level of IL-2 produced by lymphocytes stimulated by specific antigens in the patient's blood was detected using enzyme-linked immunosorbent assay(ELISA).Results From December 2022 to February 2023,a total of 199 patients with suspected symptoms of pulmonary tuberculosis were included in this study.of these,138 were clinically diagnosed with active tuberculosis,and 58 were clinically confirmed cases.The sensitivity of T-SPOT.TB in diagnosing active tuberculosis was 89.13%(123/138),specificity was 65.57%(40/61),posi-tive predictive value was 85.42%(123/144),and negative predictive value was 72.72%(40/55).The sensitiv-ity and specificity of IL-2 in diagnosing active tuberculosis were 84.1%(116/138),88.50%(54/61),the posi-tive predictive value was 94.30%(116/123),and the negative predictive value was 71.05%(54/76).The speci-ficity of IL-2 and T-SPOT.TB in diagnosing active tuberculosis was 88.50%(54/61)and 65.57%(40/61),re-spectively,with a statistically significant differences(χ^(2)=9.085,P<0.05).Conclusion IL-2,stimulated by tuberculosis-specific antigen has high sensitivity and specificity in diagnosing active tuberculosis.It is a poten-tially important marker for distinguishing active tuberculosis from latent tuberculosis infection.