ELISPOT检测在结核性脑膜炎诊断中的研究  

Application of ELISPOT in the diagnosis of tuberculous meningitis

作　　者：潘燕玉[1,2] 李津[1] 王心静[3] 杨秉芬[3] 程小星[3] 

机构地区：[1]南京军区福州总医院结核科,福建福州350003 [2]中国人民解放军军事医学科学院研究生队,北京100850 [3]中国人民解放军总参谋部总医院结核病研究所,北京100091

出　　处：《临床肺科杂志》2015年第2期204-206,共3页Journal of Clinical Pulmonary Medicine

基　　金：南京军区面上课题(No 10MA113)

摘　　要：目的利用酶联免疫斑点法(ELISPOT)检测脑脊液中结核抗原特异性的INF-γ分泌细胞数量,研究其在结核性脑膜炎诊断中的价值。方法对104例结核性脑膜炎患者和40例非结核性脑膜炎患者进行脑脊液与血的ELISPOT检测,并与脑脊液抗酸染色涂片、结核菌培养、荧光定量PCR、结核抗体检测进行敏感度和特异性的比较。结果脑脊液ELISPOT检测的敏感度为67.3%、特异性为89.2%,PV+值94.3%优于其他检测方法,差别具有统计学意义(P<0.05),脑脊液ELISPOT检测具有较好的诊断价值(Kappa=0.856,P<0.001)。结论脑脊液ELISPOT检测对结核性脑膜炎诊断的敏感度及特异度高,有望成为快速诊断结核性脑膜炎的一种方法。Objective To detect antigen-specific INF-γsecreting cells in CSF by ELISPOT assay to deter-mine its clinical value for TBMdiagnosis.Methods The study selected 1 04 patients with tuberculous meningitis and 40 people without tuberculous meningitis to detect their INF-γsecreting cells in CSF and blood by ELISPOT assay. Then the results were compared with AFB staining,Mtb culture,quantitative PCR,and Mtb antibodies.Results The sensitivity of CSF-ELISPOT assay was 92.3%,the specificity was 94.1%,which were higher than other assays （P〈0.05）.The CSF-ELISPOT assay was better than other assay in the diagnosis of TBM （Kappa=0.856,P〈0.001 ）.Conclusion The CSF-ELISPOT assay,with high sensitivity and specificity,will be a rapid diagnostic method for TBM.

关 键 词：脑脊液 ELISPOT 结核性脑膜炎 诊断 

分 类 号：R529.3[医药卫生—内科学]