干扰素-γ释放试验在儿童结核感染中的应用价值  

Significance of interferon-gamma release assay in child tuberculosis infection

作　　者：钟华清[1] 徐梦华[1] 卢丽娟[1] 杜亚娟 张洁琼 徐锦[1] 

机构地区：[1]复旦大学附属儿科医院临床检验中心,上海201102 [2]上海复星长征医学科学有限公司,上海200444

出　　处：《检验医学》2016年第3期176-179,共4页Laboratory Medicine

基　　金：上海市公共卫生优秀学科带头人计划(GWDTT201221)

摘　　要：目的评价干扰素-γ(IFN-γ)释放试验(IGRA)对儿童结核感染的诊断价值。方法采用以结核分枝杆菌特异性抗原——早期分泌抗原靶6(ESAT-6)和培养滤液蛋白10(CFP-10)为基础,基于酶联免疫斑点法(ELISPOT)的IGRA(即T-SPOT)检测了2 200例非结核病患儿和34例活动性结核病患儿体内特异性T淋巴细胞分泌的IFN-γ水平,评价其在儿童活动性结核病和结核分枝杆菌潜伏感染中的敏感性和特异性,同时分析了该实验的各项影响因素。结果 T-SPOT诊断活动性结核病的敏感性为73.5%、特异性为99.0%。T-SPOT检测结果与性别、年龄、卡介苗接种史、结核病接触史、机体免疫状态和感染部位无关。结论 T-SPOT敏感性较高,特异性强,有助于儿童活动性结核病的早期快速诊断。Objective To evaluate the significance of interferon-gamma（IFN-γ） release assay（IGRA） for diagnosis of tuberculosis infection in child. Methods Mycobacterium tuberculosis-specific antigen [early-secreted antigenic target-6（ESAT-6）and culture filtrate protein-10（CFP-10）] was used. By IGRA enzyme-linked immunospot assay（ELISPOT）（T-SPOT）,34 active tuberculosis children and 2 200 non-tuberculosis children were enrolled and determined for IFN-γlevels,and the sensitivity and specificity were evaluated. Some of influential factors were analyzed. Results The sensitivity and specificity of T-SPOT for the diagnosis of active tuberculosis were 73.5% and 99.0%,respectively. The results of T-SPOT had no relationship with sex,age,Bacillus Calmette-Guerin vaccination status,the history of exposure to source case,immunity state and infection position. Conclusion T-SPOT is sensitive,specific and helpful for early and rapid diagnosis of active tuberculosis in children.

关 键 词：干扰素-γ释放试验 酶联免疫斑点法 结核感染 儿童 敏感性 特异性 

分 类 号：R446.1[医药卫生—诊断学]