T细胞斑点实验与培养液腺苷脱氨酶联合检测在结核快速诊断中的价值  

The Value of Combined Detection of T-SPOT Test and Culture Fluid Adenosine Deaminase in the Rapid Diagnosis of Tuberculosis

作　　者：李秀玉[1] 刘文娜[1] 刘畅[1] 郭在广 王红彦[1] 王培昌[1] LI Xiuyu;LIU Wenna;LIU Chang;GUO Zaiguang;WANG Hongyan;WANG Peichang(Clinical Laboratory of Xuanwu Hospital, Captital Medcial University, Beijing 100053, China)

机构地区：[1]首都医科大学宣武医院检验科,北京100053

出　　处：《标记免疫分析与临床》2021年第3期361-364,共4页Labeled Immunoassays and Clinical Medicine

基　　金：北京市医院管理局“登峰”计划(编号:DFL20180803)。

摘　　要：目的使用T细胞斑点实验(T-SPOT)配合淋巴细胞培养液中腺苷脱氨酶(ADA)的检测,研究二者联合应用对结核菌感染快速检测的价值。方法随机选取原发性肺结核、结核性胸膜炎、儿童肺结核和中枢神经系统结核患者,进行T-SPOT、淋巴细胞培养液ADA、血清ADA、胸水ADA及脑脊液ADA等检测。结果原发性肺结核等结核组患者组的血清ADA、胸水ADA和20 h培养液ADA均显著高于对照组(P<0.05),但疾病组间差异无统计学意义(P>0.05)。在相应时间点检测淋巴细胞培养液ADA可有效诊断原发性肺结核、结核性胸膜炎、儿童肺结核及神经系统结核。培养液ADA检测能将结核性胸膜炎和儿童肺结核的诊断时间由单纯T-SPOT的20 h缩短至8 h。结论在进行T-SPOT试验的同时进行淋巴细胞培养液的ADA检测能提高检测的时效性,二者联合应用能有效提高对结核病的诊断效能。Objective To evaluate the value ofcombining T-spot test(T-SPOT)with the detection of adenosine deaminase(ADA)in lymphocyte culture medium for rapid detection of tuberculosis infection.Methods The patients with primary tuberculosis,tuberculous pleurisy,childhood tuberculosis and central nervous system tuberculosis were randomly selected for T-SPOT,lymphocyte culture fluid ADA,serum ADA,pleural fluid ADA,and cerebrospinal fluid ADA tests.Results Serum ADA,pleural fluid ADA and 20-hour culture fluid ADA of primary tuberculosis and other tuberculosis patients and the latent infection group were significantly higher than those of the control group(P<0.05),but there was no significant difference between the disease groups(P>0.05).The 20-hour culture medium ADA of the disease group was higher than that of the latent infection group(P<0.05).Detection of lymphocyte culture fluid ADA at the corresponding time point could effectively diagnose primary tuberculosis,tuberculous pleurisy,childhood tuberculosis,latent infection and nervous system tuberculosis.The detection of ADA in the culture medium could shorten the diagnosis time of tuberculous pleurisy and childhood tuberculosis from 20 hours to 8 hours for T-SPOT alone.Conclusion Performing the ADA test of lymphocyte culture medium parallel with the T-SPOT test can help improve the timeliness of the test,and the combination of the two can effectively improve the diagnostic efficiency of tuberculosis.

关 键 词：T细胞斑点实验 腺苷脱氨酶 结核 诊断 

分 类 号：R52[医药卫生—内科学]