ESAT-6及CFP-10刺激颗粒酶B在儿童结核诊断中的价值  

Diagnostic value of granzyme B stimulated by ESAT-6/CFP-10 in pediatric patients with tuberculosis

作　　者：孙娜 姚聪 沈芯 王军[1] 袁纯辉 向贇[1] SUN Na;YAO Cong;SHEN Xin;WANG Jun;YUAN Chunhui;XIANG Yun(Wuhan Children′s Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430016,China;不详)

机构地区：[1]华中科技大学同济医学院附属武汉儿童医院,武汉430016 [2]湖北中医药大学,武汉430065

出　　处：《实用医学杂志》2021年第5期660-665,共6页The Journal of Practical Medicine

基　　金：武汉市科技局“黄鹤英才计划”项目;湖北省自然科学基金(编号:2018CFB164)。

摘　　要：目的探究结核特异性抗原ESAT-6/CFP-10刺激外周血单个核细胞后颗粒酶B(GrB)水平对儿童活动性结核(ATB)的诊断价值。方法选取2019年1-8月武汉市金银潭医院和武汉儿童医院86例儿童,[ATB 26例、结核潜伏感染(LTBI)20例、非结核病对照(Non-TB)20例,健康对照(HC)20例],ELISA检测ESAT-6/CFP-10刺激外周血单个核细胞后GrB水平,流式细胞术检测表达GrB和干扰素-γ(IFN-γ)的CD4^(+)T、CD8^(+)T细胞比例。结果ESAT-6/CFP-10刺激后结核组特异性GrB较对照组显著升高(P<0.001),且LTBI组显著高于ATB组(P<0.001)。CD4^(+)T、CD8^(+)T细胞均可分泌GrB。结论结核特异性GrB对儿童活动性结核的鉴别诊断可能具有重要价值。Objective To explore the diagnostic value of granzyme B stimulated by ESAT-6/CFP-10 in pediatric patients with tuberculosis.Methods A total of 86 children(26 children with ATB,20 with LTBI,20 Non-TB,20 healthy)from Wuhan Jinyintan Hospital and Wuhan Children′s Hospital from January to August 2019 were selected.ELISA was used to detect the level of GrB in peripheral blood after ESAT-6/CFP-10 stimulation and flow cytometry to detect the expression of GrB and IFN-γin CD4^(+)/CD8^(+)T cells.Results After ESAT-6/CFP-10 stimulation,the level of MTB-specific GrB of tuberculosis patients was significantly increased when compared with the control group(P<0.001),especially,the level of MTB-specific GrB of LTBI patients was notably higher that of ATB patients(P<0.001).GrB can be secreted jointly by CD4^(+)T and CD8^(+)T cells.Conclusion MTB-specific GrB may have great value in the differential diagnosis of active tuberculosis in pediatric patients.

关 键 词：颗粒酶B 活动性结核 ROC曲线 ESAT-6 CFP-10 

分 类 号：R446.6[医药卫生—诊断学]