酶联免疫斑点法在快速诊断活动性肺结核中的应用  

Clinical application of enzyme-linked immunospot assay for rapid detection of active pulmonary tuberculosis infection

作　　者：吴妹英[1] 王霞芳[1] 肖玉梅[1] 陈嘉臻[2] 苏晓迪[2] 王森[3] 张舒[3] 邵凌云[3] 张文宏[3] 翁心华[3] 

机构地区：[1]江苏省苏州市第五人民医院结核病科,苏州市215007 [2]复旦大学遗传所 [3]复旦大学附属华山医院感染科

出　　处：《中华实验和临床感染病杂志（电子版）》2009年第2期1-4,共4页Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition)

基　　金：国家重点基础研究发展计划(973计划)资助项目(2005CB523102);国家自然科学基金资助项目(30400369)

摘　　要：目的探讨酶联免疫斑点法(ELISPOT)在临床快速诊断活动性肺结核病中的应用价值。方法采用T-SPOT.TB试剂盒对36例明确诊断为活动性肺结核的初治患者、30例健康体检者的外周血中结核分枝杆菌特异性T淋巴细胞进行检测,同时对26例活动性肺结核患者做结核菌素(PPD)试验。结果在36例活动性肺结核初治患者和30例健康对照者中,T-SPOT检测的阳性率分别为80.6%与6.7%,此技术用于诊断初治活动性肺结核患者的敏感性为80.6%,特异性为93.3%,阳性预测值为93.5%,阴性预测值为80.0%。在26例同时做PPD试验的活动性肺结核患者中,T-SPOT检测的阳性率略高于PPD试验(80.6%vs 61.5%),但差异无明显统计学意义(P>0.05)。结论酶联免疫斑点法是一种具有较高敏感性和特异性的检测结核感染的技术,在活动性肺结核病的快速诊断中有较大应用价值。Objective To evaluate the clinical application of enzyme-linked immunospet （ELIS- POT） assay for rapid detection of active pulmonary tuberculosis. Methods Rapid T-SPOT. TB assay was employed to detect Mycobacterium tuberculosis antigen specific T cells in blood samples from 36 patients with active pulmonary tuberculosis receiving initial anti-tuberculosis treatment shorter than 1 month and 30 healthy individuals. The conventional PPD skin test was performed on 26 patients with active tuberculosis at the same time. Results By the T-SPOT. TB assay, positive rates for the 36 patients with active tuberculosis and 30 healthy controls were 80.6% and 6. 7%, respectively. For diagnosing active pulmonary tuberculosis, this assay had a sensitivity of 80.6%, specificity of 93.3%, positive predictive value of 93.5% and negative predictive value of 80.0%. The positive rate of T-SPOT. TB assay was higher than that of PPD skin test in 26 patients （80.6% vs 61.5% ）, but no significant difference was found （P 〉 0.05 ）. Conclusions T- SPOT. TB assay is a rapid, more sensitive and specific method for detecting Mycobacterium tuberculosis infection. It will be a useful tool to early and rapidly diagnose active pulmonary tuberculosis infection in China.

关 键 词：活动性肺结核 分枝杆菌 诊断 结核菌素试验 酶联免疫斑点(ELISPOT)技术 

分 类 号：R446.6[医药卫生—诊断学] R521[医药卫生—临床医学]