结核菌特异性Elispot检测IFN-γ对肺结核病诊断及其治疗的指导意义  

The diagnosis and treatment guidance with TB-specific IFN-γ Elispot detection of TB

作　　者：李永兴 陶学芳 尉理梁 

机构地区：[1]浙江省绍兴市立医院呼吸科,浙江绍兴312000

出　　处：《中国现代医生》2015年第33期21-24,共4页China Modern Doctor

基　　金：浙江省医药卫生一般研究计划(A类)(2013KYA209);浙江省绍兴市科技计划项目(2011A33007)

摘　　要：目的探讨结核菌特异性Elispot检测IFN-γ对肺结核病诊断及其治疗的指导意义。方法选择我院2011年1月-2014年12月收治的肺结核患者100例,所有患者入组期间均采用住院观察,并持续住院时间均在3 d以上,先行Elispot检测,1 d后行PPD实验,比较确诊患者Elispot检测结果与PPD实验结果、Elispot检测阳性与阴性结果中斑点形成细胞数与Elispot检测卡介苗接种前后IFN-γ分泌水平。结果卡介苗接种前后IFN-γ分泌中ESAT-6水平和Pool A水平差异无统计学意义（P〉0.05）,Elispot检测阳性结果中斑点形成细胞数显著多于阴性（P〈0.05）,Elispot检测法的阳性率为88.0%,灵敏度为90.5%,特异度为19.2%,PPD实验的阳性率为74.0%,灵敏度为76.1%,特异度为41.7%,Elispot检测法阳性率和灵敏度均高于PPD实验（P〈0.05）。结论结核菌特异性IFN-γElispot检测对于筛查肺结核感染患者具有明显优势,其不受接种卡介苗与否的影响,其阳性率和敏感性均显著高于常规PPD试验。Objective To investigate the diagnosis and treatment guidance with TB-specific IFN-γ Elispot detection of TB. Methods A total of 100 cases of tuberculosis patients in our hospital from January 2011 to December 2014 were treated, all patients were enrolled in our hospital, and with continued hospital stay were more than three days, the advance of Elispot detection, PPD test after 1 day, then confirmed Elispot results in patients with PPD, Elispot test positive and negative results in the formation of spots around the level of IFN-γ secreting cells and BCG vaccination Elispot detected were comparaed. Results IFN-γ secretion of ESAT-6 level and Pool A level before and after BCG vaccination had no statistically significance（P〉0.05）, Elispot positive test results in spot-forming cells was significantly higher than negative ones（P〈0.05）, Elispot assay with positive rate was 88.0%, sensitivity was 90.5%, specificity was 19.2%, positive PPD test was 74.0% and the sensitivity was 76.1%, specificity was 41.7%, positive rate with elispot assay sensitivity was higher than PPD Experiment（P〈0.05）. Conclusion TB-specific with IFN-γ Elispot detection screening for tuberculosis patients infected has a clear advantage, it is not whether or not the impact of BCG vaccination, the positive rate and sensitivity were significantly higher than conventional PPD test.

关 键 词：结核菌特异性 ELISPOT检测 IFN-Γ 肺结核 

分 类 号：R52[医药卫生—内科学]