T-SPOT.TB在肺结节病与肺结核鉴别诊断中的应用价值  

The value of T-SPOT.TB in the differential diagnosis of sarcoidosis and pulmonary tuberculosis

作　　者：叶秋月[1] 许文兵[2] 刘晓清[3] 张丽帆[3] 

机构地区：[1]中国医学科学院北京协和医学院北京协和医院国际医疗部,北京100730 [2]中国医学科学院北京协和医学院北京协和医院呼吸内科,北京100730 [3]中国医学科学院北京协和医学院北京协和医院感染内科,北京100730

出　　处：《基础医学与临床》2014年第4期527-530,共4页Basic and Clinical Medicine

摘　　要：目的通过T-SPOT-TB检测，探讨其在肺结节病和肺结核鉴别诊断中的应用价值。方法检测2008年1月至2011年3月在北京协和医院确诊的44例肺结节病和30例肺结核患者并进行对比。结果44例肺结节病患者T-SPOT．3B阳性12例（27．3％），30例肺结核患者阳性27例（90％）；肺结节病患者ESAT-6和CFP．10肽段合并的分泌IFN-7细胞频数是46 SFCs／106 PBMC（IQR28～204），显著低于肺结核患者565SFCs／106 PBMC（IQR170～2340）。结论T-SPOT-TB检测有助于鉴别诊断肺结节病与肺结核。Objective T-SPOT. TB is a new method to diagnose tuberculous infection through detecting the fre- quencies of IFN-y/producing T cells which respond to the M. tuberculosis specific antigens encoded by the RD1 re- gion（ ESAT-6 and CFP-10）. This study aimed to evaluate the role of T-SPOT. TB in the differentiation of the sar- coidosis and tuberculosis. Methods The data of T-SPOT. TB of 44 sarcoidosis and 30 pulmonary tuberculosis pa- tients in PUMCH between January 2008 and March 2011 were analysed. Results Among the 44 sarcoidosis pa- tients, the T-SPOT. TB result was positive in 12 patient （27.3 % ）, while among the 30 pulmonary tuberculosis pa- tients ,the T-SPOT. TB result was positive in 27 patient （90%）. Pooled frequencies of ESAT-6 and CFP-10 specific IFN-~/secreting T cell was 46SFCs/106pBMC（ IQR 28 -204） for sarcoidosis patients, significantly lower than that for pulmonary tuberculosis patients which was 565 SFCs/106pBMC（ IQR 170 -2340）. Conclusions T-SPOT. TB is a potential method for the differentiation of sarcoidosis from pulmonary tuberculosis.

关 键 词：肺结节病 肺结核 鉴别诊断 ELISPOT T-SPOT-TB 

分 类 号：R521[医药卫生—内科学] R593.9[医药卫生—临床医学]