IFN-γ ELISPOT效应性T细胞在结核性脑膜炎和肺结核中的临床价值  

The value of effector T cells in patients with tuberculous meningitis and pulmonary tuberculosis by IFN-γ enzyme-linked immunospot assay

作　　者：陈萍[1] 冯国栋[1] 杨毅宁[1] 朱旗[1] 张敏[1] 赵钢[1] 

机构地区：[1]第四军医大学西京医院神经内科,陕西710032

出　　处：《脑与神经疾病杂志》2016年第9期533-536,共4页Journal of Brain and Nervous Diseases

基　　金：国家自然科学基金项目(81371334)

摘　　要：目的明确结核性脑膜炎(TBM)和肺结核(PTB)患者结核分枝杆菌抗原特异性干扰素-γ酶联免疫斑点(IFN-γELISPOT)的数量差异,分析IFN-γ水平变化在TBM和PTB中的作用。方法通过TBM,PTB患者和健康人的外周血进行IFN-γELISPOT检测,比较效应性T细胞的数量差异,并通过1年随访,比较TBM和PTB患者IFN-γELISPOT阳性组和阴性组预后的差异。结果 TBM组IFN-γELISPOT阳性率为37.1%(13/35),PTB组IFN-γELISPOT阳性率为76.0%(19/25)。TBM组IFN-γELISPOTA(ESAT-6)和B(CFP-10)明显低于PTB组(P<0.05);患者的1年随访分析表明TBM和PTB患者IFN-γELISPOT阳性组GOS预后分析好于阴性组。结论 TBM患者IFN-γ水平明显低于PTB患者,相对低的IFN-γ的表达是预后不良机制之一,外源性IFN-γ补充可能使TBM患者获益。Objective To explicit the different level of effector T cells by IFN- γ enzyme-linked immunospot assay （ IFN- γ ELISPOT ） of peripheral blood in patients with tuberculous meningitis （ TBM ） and pulmonary tuberculosis （ PTB ） and analyze the function of level of IFN- γ release. Method By IFN- γ ELISPOT assay of peripheral blood in patients with TBM and PTB and healthy controls,to compare with the population of effector T cells between patients with TBM and PTB. By one year follow-up,to compare the prognosis of patients with TBM and PTB in the positive and negative IFN- γ ELISPOT groups. Results By IFN- -y ELISPOT assay,positivity rates in patients with TBM and PTB were 37.1%,76.0%, respectively.IFN- γ ELISPOT-A （ ESAT-6 ） and B （ CFP-10 ） in patients with TMB were lower than that in patients with PTB （ P〈0.0001 ） ; In GOS prognosis analysis ,the groups of positive IFN-γ ELISPOT were better than those of negative IFN-γ ELISPOT in patients with TBM and PTB. Conclusion IFN-γ in patients with TMB were lower than that in patients with PTB.TB-exposed individuals correlates with relatively lower IFN-γ expression suggesting a mechanism for the previously observed poor prognosis.Exogenous IFN-γ supplementation may benefit patients with TBM.

关 键 词：结核性脑膜炎 肺结核 干扰素-Y 酶联免疫斑点检测 

分 类 号：R529.3[医药卫生—内科学]