T-SPOT.TB在活动性肺结核治疗效果的监测  

Efficacy of T-SPOT.TB in Treatment of Active Tuberculosis

作　　者：万荣 李明武 马萌 赖明红 李光妹 WAN Rong;LI Ming-wu;MA Meng;LAI Ming-hong;Li Guang-mei(No.2 Dept.of Tuberculosis,The 3rd People’s Hospital of Kunming,Kunming Yunnan 650041,China)

机构地区：[1]昆明市第三人民医院结核二科,云南昆明650041

出　　处：《昆明医科大学学报》2020年第12期133-137,共5页Journal of Kunming Medical University

基　　金：昆明市卫健委医药卫生科技计划基金资助项目(2018-03-08-003)。

摘　　要：目的探讨结核感染T细胞斑点试验(T-SPOT.TB)对肺结核治疗效果的监测意义。方法采用TSPOT.TB试剂盒,检测其抗原ESAT-6和CFP-10的应答,对比79例活动性肺结核患者治疗前与治疗2月末及治疗结束时ESAT-6和CFP-10应答结果的变化。结果 79例活动性肺结核患者,ESAT-6和CFP-10应答的斑点数在治疗2月末和治疗结束时较治疗初均有明显下降,与治疗初比较,差异均有统计学意义(P <0.05)。ESAT-6和CFP-10在治疗2月末和治疗结束时阴性率较治疗初有上升,与治疗初的阴性率比较,差异无统计学意义(P> 0.05);全部患者T-SPOT.TB转阴率为3.8%。治疗2月末与治疗结束时ESAT-6应答变化,差异有统计学意义(χ^(2)=4.635,P=0.031 <0.05);治疗2月末与治疗结束时CFP-10应答变化,差异无统计学意义(χ^(2)=1.272,P=0.259> 0.05)。结论 T-SPOT.TB治疗前后ESAT-6、CFP-10应答变化有明显差异,对肺结核治疗效果评价有一定作用,但不能利用其转阴率作为肺结核治疗停药指标。Objective To explore the significance of T-SPOT.TB test for monitoring the therapeutic effect of tuberculosis.Methods Using T-SPOT.TB kit,changes in response to ESAT-6 and CFP-10 were compared in 79 patients with active pulmonary tuberculosis before and after 2 months of treatment.Results In 79 patients with active pulmonary tuberculosis,The spot number of ESAT-6 and CFP-10 responses decreased significantly at the end of 2 months and at the end of treatment compared with the beginning of treatment,and the difference was statistically significant(P<0.05).The negative rates of ESAT-6 and CFP-10 at the end of 2 months and at the end of treatment were higher than those at the beginning of treatment,but there was no significant difference between them(P>0.05).The T-SPOT.TB negative conversion rate of all patients was 3.8%.There was a statistical difference in ESAT-6 response between the end of 2 months and the end of treatment(χ^(2)=4.635,P=0.031<0.05).There was no significant difference in CFP-10 response at the end of treatment 2 and at the end of treatment(χ^(2)=1.272,P=0.259>0.05).Conclusion There were significant differences in ESAT-6 and CFP-10 of T-SPOT.TB responses before and after treatment.T-SPOT has a certain significance in evaluating of the therapeutic effect of tuberculosis,but its negative conversion ration can not be used as the indicator of ending the TB treatment.

关 键 词：结核感染T细胞斑点试验 ESAT-6 CFP-10 肺结核 治疗效果 

分 类 号：R521[医药卫生—内科学]