结核患者的治疗跟踪及密切接触者的调查研究  

Tracking treatment of tuberculosis patients and investigation of latent tuberculosis

作　　者：刘纯成[1] 刘林飞[1] 李桂珍[2] 张远涛[1] 时玉军 杨鹏飞[1] 刘靓[1] 

机构地区：[1]江苏省淮安市疾病预防控制中心检验科,江苏淮安223001 [2]江苏省淮安市第四人民医院检验科,江苏淮安223001

出　　处：《中国现代医生》2015年第28期122-125,共4页China Modern Doctor

基　　金：江苏省预防医学科研课题(Y2012005)

摘　　要：目的评价结核感染T细胞斑点试验（T—SPOT．TB）对潜伏性结核诊断及结核患者治疗效果评价的应用价值。方法选择2012年12月-2014年8月44例治疗后肺结核患者、50例治疗后的肺外结核患者、45例潜伏结核患者（3个月服药后）、92例肺结核病家庭密切接触者、肺外结核患者家庭密切接触者45例、结核病防治工作者31例、88例非结核患者家庭密切接触者，进行外周血T—SPOT．TB检测。结果治疗后肺结核患者、治疗后肺外结核患者和潜伏结核患者（3个月服药后）阳性率分别为52．27％、52．00％和55．56％，正常人群阳性率为6．82％，三种类型患者阳性率与正常人群阳性率相比差异均具有统计学意义（P〈0．01）；肺结核患者家庭密切接触者、肺外结核患者家庭密切接触者和结核病防治医务工作者的阳性率分别为30．43％、11．11％和19．35％，肺结核患者家庭密切接触者阳性率与正常人群阳性率相比差异具有统计学意义（P〈0．01），而肺外结核患者家庭密切接触者和结核病防治医务工作者与正常人群相比差异无统计学意义（P〉0．05）。结论酶联免疫斑点T—SPOT．TB实验检测结核敏感性强、特异性高，是快速诊断潜伏性结核感染的有效方法，是对结核患者的治疗效果作出评价的有效手段，为结核病的防控提供了一个非常好的监测手段。Objective To investigate the value of T cells spot test （T-SPOT.TB） in tracking treatment of tuberculosis patients and investigation of latent tuberculosis. Methods From December 2012 to August 2014, peripheral blood T- SPOT.TB were measured in the 44 patients with active tuberculosis, 50 patients with extra-pulmonary tuberculosis, 45 patients with latent tuberculosis, 92 patients with close contactors of active tuberculosis, 45 patients with close contac- tors of extra-pulmonary tuberculosis, 31 medical workers of tuberculosis control and 88 healthy individuals. Results The positive rate of T-SPOT.TB for the diagnosis of active tuberculosis, extra-pulmonary tuberculosis, latent tuberculosis were 52.27%, 52.00%, 55.56%, and healthy individuals was 6.82%, The positive rate of those three kinds of patients was statistically significant with the positive rate of healthy individuals （P〈0.01）. The positive rate of close contactors of active tuberculosis, close contactors of extra-pulmonary tuberculosis, medical workers of tuberculosis control were 30.43%, 11.11% and 19.35%. The positive rate of close contactors of active tuberculosis was statistically significant with the positive rate of healthy individuals （P〈0.01）, while the positive rate of close contactors of extra-pulmonary tuberculosis and medical workers of tuberculosis control was no statistically significant with the positive rate of healthy individuals（P〉0.05）. Conclusion T-SPOT.TB assay can be an effective method for repaid diagnosis of latent tuberculosis infection and the treatment of tuberculosis patients with high specificity and sensitivity, and also is a very useful method for the prevention and control of tuberculosis.

关 键 词：结核病 潜伏性结核 结核感染T细胞斑点试验 阳性率 

分 类 号：R521[医药卫生—内科学]