酶联免疫斑点试验在菌阴肺结核诊断中的价值  

Diagnostic value of enzyme-linked immunospot assay for diagnosis of smear-negative pulmonary tuberculosis

作　　者：曾谊[1] 冯枭[1] 宋梅梅[1] 林云霞[1] 费贤树[1] 袁广琴 

机构地区：[1]南京市胸科医院结核科,210029

出　　处：《中国防痨杂志》2012年第2期100-102,共3页Chinese Journal of Antituberculosis

摘　　要：目的探讨酶联免疫斑点检测技术(enzyme-linked immunospot assay,ELISPOT)(T-SPOT.TB)在菌阴肺结核诊断中的应用价值。方法应用T-SPOT.TB试剂盒对55例菌阴肺结核(A组)和36例其他肺部疾病(B组)患者的外周血中Mtb特异性T淋巴细胞进行检测,同时对两组患者进行PPD试验、血清结核抗体(Mtb-AB)检测。结果A组T-SPOT.TB的阳性率为89.1%(49/55),要明显高于B组的19.4%(7/36)(χ2=44.59,P<0.001)。在A组,T-SPOT.TB的阳性率要明显高于PPD试验[36.4%(20/55)]、Mtb-AB[52.7%(29/55)]及PPD试验+Mtb-AB的阳性率[23.6%(13/55)],(χ2=12.13,χ2=7.08,χ2=21.54,P值均<0.01)。T-SPOT.TB在B组中的阴性率为80.6%(29/36),较PPD试验[86.1%(31/36)]及Mtb-AB阴性(63.9%,23/36)和PPD+Mtb-AB检测方法的阴性率[88.9%(32/36)]经检验,差异无统计学意义(χ2=0.39,χ2=2.69,χ2=0.41,P值均>0.05)。结论T-SPOT.TB检测特异度和敏感度要优于PPD试验及Mtb-AB的检测,可用于菌阴肺结核的辅助诊断,具有一定的临床推广使用的价值。Objective To explore the value of enzyme-linked immunospot assay（ELISPOT）（T-SPOT.TB） in diagnosis of smear-negative pulmonary tuberculosis.Methods Rapid T-SPOT.TB assay was employed to detect Mycobacterium tuberculosis antigen specific T cells in blood samples from 55 cases with smear-negative pulmonary tuberculosis（A group） and 36 cases with non-TB pulmonary disease（B group）,The conventional PPD skin test and serum tuberculosis antibody were performed in two groups at the same time.Results By the T-SPOT.TB assay,the positive rate in A group was 89.1%（49/55）,it was significantly higher than that of B group 19.4%（7/36）（χ2=44.59,P〈0.001）.In A group,the positive rate of T-SPOT.TB assay was much higher than the positive rate of PPD test and serum tuberculosis antibody and the positive rate of PPD test combination with serum tuberculosis antibody（χ2=12.13,χ2=7.08,χ2=21.54,P〈0.01）.In B group,the negative rate of T-SPOT.TB assay was 80.6%（29/36）,it was no significant difference than the negative rate of PPD test and serum tuberculosis antibody and the negative rate of PPD test combination with serum tuberculosis antibody（χ2=0.39,χ2=0.41,P〉0.05）.Conclusion T-SPOT.TB assay is superior specificity and sensitivity of PPD test and serum antibody.It will be a useful tool to diagnose early smear-negative pulmonary tuberculosis.T-SPOT.TB is worth further to expand in the clinical application.

关 键 词：结核 肺/诊断 免疫酶技术 结核菌素试验 

分 类 号：R521[医药卫生—内科学]