干扰素-γ、人类白细胞抗原-G、结核抗体联合检测在骨关节结核诊断中的临床应用  

Clinical application of combined detection of interferon-γ,human leukocyte antigen-G and tuberculosis antibody in the diagnosis of bone and joint tuberculosis

作　　者：陈浩全 曾嫚妮[2] CHEN Hao -quan;ZENG Man -ni(Department of Laboratory Medicine,Yulin Orthopedics Hospital of Integrated Traditional Chinese and Western Medicine,Yuli,Guangxi 537000,China)

机构地区：[1]广西玉林市中西医结合骨科医院检验科,广西玉林537000 [2]广西玉林市第一人民医院检验科,广西玉林537000

出　　处：《中国卫生检验杂志》2019年第2期236-238,共3页Chinese Journal of Health Laboratory Technology

摘　　要：目的探讨外周血特异性T细胞IFN-γ(TB-IGRA)和人类白细胞分化抗原G(HLA-G)、结核抗体联合检测在骨关节结核临床诊断方面的应用价值。方法将2015年7月-2017年7月住院并手术诊治的骨关节疾病患者215例,经细菌学和组织病理学确诊后分为骨关节结核患者121例和非结核骨关节疾病患者94例,采用ELISA法检测结核特异性T细胞IFN-γ和s HLA-G的表达,流式细胞分析法检测m HLA-G的表达,免疫印迹法检测结核抗体,观察各指标及3项联合检测对骨关节结核的诊断价值。结果单指标检测抗TB-IGRA、s HLA-G、m HLA-G、结核抗体对骨关节结核的敏感度分别为86. 77%、70. 24%、66. 94%、63. 63%;特异度分别为60. 63%、72. 34%、70. 21%、80. 85%;4项指标联合检测敏感度为88. 42%,特异度为85. 10%。结论结核抗体检测在骨关节结核临床诊断方面特异性高,但敏感性较低,而外周血特异性T细胞IFN-γ和HLA-G有较高敏感性,4项指标联合检测能显著提高敏感性和特异性,降低骨关节结核的误诊率,有较高的临床应用价值。Objective To investigate the value of combined detection of peripheral blood specific T lymphocyte IFN gamma( TB IGRA) and human leukocyte differentiation antigen G( HLA G) and tuberculosis antibody in clinical diagnosis of bone and joint tuberculosis. Methods A total of 215 hospitalized patients with bone and joint disease who received surgery from July 2015 to July 2017,according to bacteriological and histopathological diagnosis,were divided into 121 patients with bone and joint tuberculosis and 94 patients with non-tuberculous bone and joint disease. The expressions of TB-γ and s HLA-G in tuberculosis-specific T cells were detected by ELISA. The expression of m HLA-G was detected by flow cytometry. The tuberculosis antibody was detected by immunoblotting. The indicators and diagnostic value of the three-joint detections for bone and joint tuberculosis were observed. Results The sensitivity of single index detection of anti TB-IGRA,s HLA-G,m HLA-G,antibodies to Mycobacterium tuberculosis in bone and joint were 86. 77%,70. 24%,66. 94%,63. 63%,respectively; the specificity was60. 63%,72. 34%,70. 21%,80. 85%,respectively; the combined detection sensitivity of the four indicators was 88. 42%and the specificity was 85. 10%. Conclusion Tuberculosis antibody detection is highly specific in the clinical diagnosis of bone and joint tuberculosis,but the sensitivity is low,while peripheral blood-specific T cells IFN-γ and HLA-G have higher sensitivity. The combined detection of 4 indicators can significantly improve the sensitivity and specificity,reduce the misdiagnosis rate of bone and joint tuberculosis,and has high clinical application value.

关 键 词：骨关节结核 特异性T细胞IFN-γ 人类白细胞分化抗原G 结核抗体 

分 类 号：R529.2[医药卫生—内科学]