1873例结核感染T细胞斑点试验检测阳性患者的临床分析  

Clinical analysis of positive T-SPOT. TB in 1873 cases with active tuberculosis

作　　者：张娟[1] 孙娇[1] 李莹[1] 王悦[1] 孙秀华[1] 马静红[1] 邢黎莉 谭珂[1] 彭娇[1] 孙炳奇[1] 

机构地区：[1]沈阳市胸科医院结核病实验室,110044

出　　处：《中国防痨杂志》2015年第7期778-783,共6页Chinese Journal of Antituberculosis

基　　金：沈阳市科技计划项目（F12-255-1-00）

摘　　要：目的探讨结核感染T细胞斑点试验（T-SPOT．TB）检测结果与结核病患者临床表现的相关性。方法选取临床确诊结核病且T-SPOT．TB检测阳性患者1873例，并从患者的基本情况、细菌学、影像学及常规检查等4个方面对T-SPOT．TB检测结果[SFCs（个）／10^6 PBMCs]与结核病患者临床表现的相关性进行比较分析。结果初治患者外周血单核细胞（PBMCs）中斑点形成细胞（SFCs）数[A孔中位数17个，B孔中位数13个]明显高于复治患者[-A孔中位数9个，B孔中位数9个]（A孔U--364391．5，P％0．01；B孔u=364259．0，P〈0．01）；中青年患者SFCs数EA孔中位数17个，B孔中位数12个]明显高于老年患者[A孔中位数9个，B孔中位数9个]（A孔U=304368．5，P％0．01；B孔U=302802．0，P〈0．01）；菌阳患者的SFCs数[A孔中位数27个，B孔中位数20个]明显高于菌阴患者[A孔中位数10个，B孔中位数10个]（A孔u=298504．0，P％0．01；B孔u=279815．5，P〈0．01）；肺部有空洞的患者SFCs数[A孔中位数32个，B孔中位数25个]明显高于肺部无空洞的患者[A孔中位数10个，B孔中位数9个]（A孔u=208015．5，P〈0.01；B孔u=216424．5，P〈0．01）；外周血单核细胞升高的患者SFCs数[A孔中位数21个，B孔中位数20个]明显高于外周血单核细胞正常的患者EA孔中位数10个，B孔中位数9个]（A孔U=308522．0，P〈0．01；B孔U=307748．0，P〈0．01）。结论T-SPOT．TB的SFCs计数虽然并不能完全与结核病活动程度呈正相关，但仍然存在着结核病活动程度越高SFCs数越多的趋势。Objective To explore the relationship between the spot forming cells （SFCs） of T-SPOT. TB and clinical manifestation of tuberculosis. Methods One thousand eight hundred and seventy three patients with active tuberculosis and T SPOT. TB positive result were enrolled in this study. The correlation between T-SPOT. TB results and clinical manifestations of tuberculosis patients was compared and analyzed based on the demographic da- ta, bacteriology, imaging characteristics and blood routine examination. Results The median of SFCs of Tspot in primary patients （A： 17,B： 13）was significantly higher than that of retreatment patients（A： 9,B： 9） （U value of A was 364 391.5,P〈0.01;U value of B was 364 259.0,P〈0.01） ;The median of SFCs of Tspot in young to middle- aged patients （A： 17, B： 12） was significantly higher than that in the elderly patients （A： 9, B： 9） （U value of A was 304 368.5 ,P〈0. 01 ;U value of B was 302 802.0, P〈0.01） ;The median of SFCs of bacteriology positive patients （A： 27, B： 20） was significantly higher than that of bacteriology negative patients （ A： 10, B： 10） （U value of A was 298 504. 0, P〈0.01;U value of B was 279 815.5, P〈0.01）;The median of SFCs of patients with cavity in lung（A： 32, B： 25） is higher than that in patients with no cavity in lung（A： 10, B： 9）（U value of A was 208 015.5, P〈0.01; U value of B was 216 424.5,P〈0.01）;The median of SFCs of patients with higher mononuclear cells （A： 21, B： 20）was significantly higher than that in patients with normal mononuclear cells（A： 10, B： 9）（U value of A was 308 522.0,P〈0.01;U value of B was 307 748.0,P〈0.01）. Conclusion SFCs of T-SPOT. TB cannot be related with tuberculosis activity, but the trends of more high tuberculosis activity level accompany with more SFCs can befound.

关 键 词：潜伏性结核/诊断 酶联免疫斑点测定 

分 类 号：R446.11[医药卫生—诊断学]