结核感染T细胞斑点试验诊断HIV/AIDS患者潜伏感染结核分枝杆菌的实验研究  

Experimental studies on an enzyme-linked immunospot assay for diagnosing latent tuberculosis infection in HIV-positive individuals

作　　者：钟敏[1,2] 孙丽萍[1] 张淑萍[1] 荆明[1] 王滨有[2] 周晋[3] 王福祥[1] 

机构地区：[1]哈尔滨医科大学附属第一医院感染科,黑龙江哈尔滨150001 [2]哈尔滨医科大学流行病学教研室,黑龙江哈尔滨150081 [3]哈尔滨医科大学附属第一院血液科,黑龙江哈尔滨150001

出　　处：《哈尔滨医科大学学报》2013年第4期329-332,共4页Journal of Harbin Medical University

基　　金：国家"十一五"科技重大专项(2008ZX10001-008)

摘　　要：目的评价结核感染T细胞斑点试验(TSPOT-TB)在HIV/AIDS患者中诊断潜伏感染结核分枝杆菌(mycobacterium tuberculosis,MTB)的应用价值,了解HIV/AIDS患者中结核的感染情况。方法应用TSPOT-TB试剂盒对55例明确诊断为HIV感染者的血液标本进行结核分枝杆菌特异性T细胞的检测,同时对所有病例采用ELISA法血清抗结核抗体试验检测结核分枝杆菌。结果在总体HIV/AIDS患者、CD4+T淋巴细胞>200/μL和<200/μL组中,TSPOT-TB检测阳性率分别为30.91%、23.52%和34.21%,ELISA检测阳性率分别为14.55%、11.76%和15.79%;在总体HIV/AIDS患者中,TSPOT-TB检测阳性率高于ELISA,差异有统计学意义(P<0.05)。在CD4+T淋巴细胞>200/μL和<200/μL组中,TSPOT-TB检测阳性率均高于ELISA检测阳性率,但差异无统计学意义(P均>0.05)。TSPOT-TB检测在CD4+T淋巴细胞>200/μL组中的阳性率(23.52%)略低于CD4+T淋巴细胞<200/μL组(34.21%),ELISA检测在CD4+T淋巴细胞>200/μL组中的阳性率(11.76%)略低于CD4+T细胞<200/μL组(15.79%),差异均无统计学意义。结论采用TSPOT-TB检测HIV/AIDS患者中MTB潜伏感染阳性率高于ELISA,TSPOT-TB检测对HIV/AIDS患者中MTB潜伏感染的诊断有较大应用价值。Objective To validate sensitivity of a new enzyme linked immunospot assay （TS- POT-TB） and evaluate the application of TSPOT-TB in diagnosing latent tuberculosis （TB） infection individuals that comprehend latent tuberculosis （TB） infection. Methods The rapid TSPOT-TB assay was employed to detect ESAT-6 and CFP-10 specific T cells in blood samples from 55 HIV-positive individuals. Detection of anti-tuberculosis antibody performed on all patients as a positive control. Results Using the TSPOT-TB assay, positivity rates for the 55 HIV-positive individuals, HIV-positive individuals with CD4 cell counts less than 200/μL and HIV-positive individuals with CD4 cell counts more than 200/μL were 30. 91%, 23.52% and 34.21%, respectively. Detection of anti-tuberculosis antibody were 14. 55%, 11.76% and 15.79% in these three groups, respectively. The positive rates obtained from the use of the TSPOT-TB assay were significantly higher than those obtained from the detection of anti-tuberculosis antibody for the HIV-positive individuals included the current study, including those with CD4 cell counts greater than 200/μL（P 〈 0.05 ） and with CD4 cell counts lower than 200/μL （P 〉 0. 05 ）. The positivity rate obtained from the TSPOT-TB assay was not significantly affected by the patients＇ CD4 cell count （P 〉 0. 05 ）. In contrast, the positive rate obtained through detection of anti-tuberculosis antibody was significantly decreased in HIV-positive individuals with CD4 cell counts more than 200/IxL （P 〉 0. 05 ）. Conclusion The positive rates obtained from the use of the TSPOT-TB assay are significantly higher than those from detection of anti-tuberculosis antibody, so that TSPOT-TB assay will be a useful tool in early and rapid diagnosis of latent tuberculosis infection in HIV-positive individuals.

关 键 词：获得性免疫缺陷综合征 结核分枝杆菌 酶联免疫吸附测定 抗结核抗体 

分 类 号：R52[医药卫生—内科学]