酶联免疫斑点技术对儿童结核病诊断的应用价值  

Clinical Application of Enzyme-linked Immunospot Assay in Dignosis of Pediatric Tuberculosis

作　　者：孟珊珊[1] 张乐乐[1] 张海邻[1] 胡晓光[1] 张维溪[1] 苏苗赏[1] 罗运春[1] 

机构地区：[1]温州医学院附属育英儿童医院呼吸科,325027

出　　处：《医学研究杂志》2013年第10期151-154,共4页Journal of Medical Research

摘　　要：目的研究ELISPOT试验在儿童结核病临床诊断中的应用价值。方法对2011年11月～2012年11月入住笔者医院的32例儿童结核病患儿及38例非结核患儿进行痰涂片分析、结核抗体检测、PPD试验及ELISPOT试验检测，比较分析不同方法的检测结果并进行统计学分析。结果ELISPOT诊断儿童结核病的敏感度为87．5％，特异性为94．7％，与PPD试验相比，敏感度和特异性均高于PPD试验，但敏感度差异无统计学意义（P=0．323），特异性差异有统计学意义（P：0．003）。而与PPD强阳性诊断结核病的敏感度和特异性比较，特异性相仿（P=0．485），敏感度显著高于PPD试验（P〈0．001）。ELISPOT试验阳性率为87．5％，显著高于痰培养及结核抗体检测阳性率，差异均有统计学意义（P〈0．01）。结论ELISPOT试验具有相对较高的敏感度和特异性，是诊断儿童结核的快速敏感方法，在儿童结核感染早期临床诊断中有重要的应用价值。Objective To explore the clinical application of enzyme - linked immunospot assay（ELISPOT） in diagnosis of pediatric tuberculosis. Methods The 32 children with tuberculosis and 38 with other respiratory diseases were enrolled and performed ELISPOT. The ELISPOT results were compared with the results of PPD test and sputum culture as well as tuberculosis antibody test. Results The sensitivity and specificity of ELISPOT were 87.5% and 94.7% , respectively. The sensitivity of ELISPOT was higher than that of PPD test, although there was no statistically significant. The specificity of ELISPOT was significantly higher than of PPD test （P = 0. 003 ）. Then compared with the strong positive results of PPD test, the specificity of ELISPOT was similar to the strong positive results of PPD test and the sensitivity of ELISPOT was significantly higher than that of PPD test（P 〈 0. 001 ）. The positive rate of ELISPOT was significantly higher than those of sputum culture and tuberculosis antibody test in children with tuberculosis （ P 〈 0.01 ）. Conclusion ELISPOT had relatively high sensitivity and specificity. It is a sensitive and fast test to diagnose pediatric tuberculosis and can be applied in early diag- nosis of tuberculosis in children.

关 键 词：结核诊断酶联免疫斑点技术儿童 

分 类 号：R52[医药卫生—内科学]