酶联免疫斑点法检测肺结核患者特异性结核抗原多肽T细胞的应答  

Evaluation of enzyme-linked immunospot assay detecting Mycobacterium tuberculosis specific T cell responses in patients with pulmonary tuberculosis

作　　者：饶英[1] 莫凌[2] 钟敏[1] 孟成艳[2] 张西燕[1] 虞胜镭[2] 陈刚[1] 王莹[2] 王菲菲[2] 陈嘉臻[2] 朱静[3] 张文宏[2] 

机构地区：[1]重庆市肺科医院,430020 [2]复旦大学附属华山医院感染科 [3]重庆医科大学附属儿童医院科研处

出　　处：《中华传染病杂志》2008年第8期467-470,共4页Chinese Journal of Infectious Diseases

基　　金：国家自然科学基金资助项目（30400369）

摘　　要：目的评价我国酶联免疫斑点法（ELISPOT）用于诊断肺结核患者的应用价值。方法结核特异性ELISPOT法检测76例诊断明确的肺结核患者外周血单核细胞。同时选择30例无结核接触史、胸部X线片无异常且PPD皮试阴性的成年人作为对照。数据采用卡方检验和非参数Mann—Whitney检验。结果76例患者总体阳性率为71．0％，健康对照组阳性率为6．7％。按照患者抗结核疗程分为治疗1个月内、治疗6个月内、治疗6个月以上3组，阳性率分别为87．5％、74．1％和52．0％（x^2=35．63，P=0．000）。该技术在初冶结核患者中的灵敏度为87．5％，特异度为93．3％，阳性预测值为91．3％，阴性预测值为90．3％。结论结核特异性ELISPOT技术在我国初治（抗结核化疗疗程1个月内）的结核病患者中具有较高诊断价值。Objective To evaluate the application of a new enzyme linked immunospot assay （ELSIPOT） based on Mycobacterium tuberculosis-sepcific T cells detection in the diagnosis of active pulmonary tuberculosis in China. Methods Using the ELISPOT assay, T cells specific for early secreted antigenic target 6-kDa protein （ESAT 6） and culture filtrate protein 10 （CFP-10） in the peripheral blood from 76 active pulmonary tuberculosis patients were measured. Thirty healthy people were recruited as healthy controls, which had no tuberculosis contacting history and were normal for chest X ray examination as well as negative for tuberculosis skin test （TST）. The data were analyzed using Chi-square test and Mann-Whitney test. Results The positive rate of ELISPOT was71. 0% （54/76） and 6. 7% （2/30） in the patients with active pulmonary tuberculosis and healthy controls respectively. Furthermore, the positive rate was as high as 87.5 % in patients with antituberculosis treatment course less than 1 month, and decreased to 74.1 % and 52.0% in the patients with the treatment course varying from 1 to 6 months and more than 6 months respectively（x^2= 35. 63, P= 0. 000）. In the patients with treatment course less than 1 month, the sensitivity, specificity, positive predictive value and negative predictive value of ELISPOT were 87.5 %, 93.3%, 91.3% and 90.3%, respectively. Conclusion ELISPOT assay is a sensitive assay for detecting tuberculosis infection, especially in the patients with anti-tuberculosis treatment course less than 1 month.

关 键 词：结核 肺 酶联免疫斑点法 T淋巴细胞 抗原 细菌 

分 类 号：R392[医药卫生—免疫学]