检测分泌r-干扰素T细胞对诊断儿童结核的意义  

Diagnosis Value of Detection Release IFN-gamma Specific-T Cells in Children with Tuberculosis

作　　者：李瑞[1] 刘继贤[2] 包丽丽[2] 丁云芳[2] 朱宏[2] 季正华[2] 

机构地区：[1]江苏省苏州市立医院东区,江苏苏州215000 [2]苏州大学附属儿童医院

出　　处：《中国医学创新》2013年第17期80-83,共4页Medical Innovation of China

基　　金：苏州市社会发展科技计划项目(编号:SS08042)

摘　　要：目的:探讨分泌r-IFN的结核杆菌特异性T细胞检测对儿童结核感染的诊断意义。方法:用流式细胞术胞内细胞因子(cytokine flow cytometry,CFC)检测法,对结核病患儿41例、潜伏结核感染(latent tuberculosis infection,LTBI)75例、健康儿童20例,测其外周血中分泌r-干扰素(IFN-r)的结核杆菌特异性CD4+T淋巴细胞;同时行结核菌素皮试(TST)和结核抗体检测。结果:(1)CFC检测,41例结核病患儿90.24%阳性,9.76%阴性;健康组1例阳性,说明该检测方法特异性为95%。(2)结核病组CFC阳性率90.24%,TST阳性率70.73%,结核抗体阳性率56.10%,与CFC比较差异均有统计学意义(P<0.05)。(3)LTBI组CFC阳性率85.33%,TST阳性率85.33%;结核抗体阳性率为28%,与CFC比较差异有统计学意义(P<0.01)。结论:(1)诊断儿童结核病,分泌r-IFN的结核杆菌特异性T细胞流式检测的敏感性、特异性比TST、结核抗体强。(2)诊断潜伏结核感染,分泌r-IFN的结核杆菌特异性T细胞流式检测与TST效果类似,比结核抗体强。Objective： To discuss the diagnosis value of detection releases IFN-gamma specific-T cells in children with tuberculosis .Method： By cytokine flow cytometry （ CFC ） for 41cases tuberculosis, 75cases latent tuberculosis infection and 20cases healthy control were tested releases IFN-gamma specific-T cells in peripheral blood meanwhile checkupTST and tuberculosis-antibody.Result： （ 1 ） By CFC, the positivity was 90.24%, negativity is 9.76%in tuberculosis cases; Healthy controls in 1 positive, explain the specificity of 95% （ 19/20 ） . （ 2 ） In tuberculosis group, the positivity was 90.24% by CFC, the positivity was 70.73% by TSTand the positivity 56.10% of tuberculosis antibody test , which compared with CFC＇ s pesitivity had statistical difference （P〈O.05） . （ 3 ） The positivity was 85.33% of CFC in groupLTBI, had a good concordance withTST. While the positivity was only 28% of tuberculosis antibody test in this group compared with C＇FC had significantly statistical difference （ P〈0.01 ） .Conclusion： （ 1 ） The method of antigen-specific-T cells IFN-gamma measured by CFC has higher sensitivityand specificity than TST and tuberculosis antibody test for diagnosis of tuberculosis. （ 2 ） In the diagnosis of LTBI, CFC and TST effect is similar, but over tuberculosis antibody test.

关 键 词：特异性T细胞 流式细胞术 结核 儿童 诊断 

分 类 号：R725.1[医药卫生—儿科]