基于CD161的流式检测技术在艾滋病合并结核诊断效能的评价  

Diagnostic efficiency of CD161 detected by flow cytometric of patients with AIDS complicated with tuberculosis

作　　者：陈骑[1] 张雅曦 詹森林[1] 张明霞[1] 方木通[1] 李国保[1] 杨倩婷[1] CHEN Qi;ZHANG Ya-xi;ZHAN Sen-lin;ZHANG Ming-xia;FANG Mu-tong;LI Guo-bao;YANG Qian-ting(Institute of Hepatology,Shenzhen Third People's Hospital,Shenzhen,Guangdong 518112,China)

机构地区：[1]深圳市第三人民医院肝病研究所,广东深圳518112

出　　处：《中国热带医学》2022年第8期703-706,723,共5页China Tropical Medicine

基　　金：国家科技重大专项(No.2017ZX10201301-001)。

摘　　要：目的评价基于CD161的流式检测技术在艾滋合并结核感染中的应用价值。方法用流式检测技术分别检测58例结核病患者(TB),55例艾滋病合并结核病患者(HIV+TB),122例艾滋病患者(HIV)及138例健康对照(HC)全血中CD161的表达水平;同时比较CD161流式检测技术、GeneXpert、TB-DNA、γ-干扰素释放试验(IGRAs)和AFB在TB-HIV中的检测阳性率。结果TB外周血中淋巴细胞和CD161的表达水平显著低于HC,相反TB中单核细胞和OR值高于HC,但不受HIV感染影响。当OR阈值>0.45时,分辨HC与TB-HIV时,AUC为0.91,灵敏度92.73%,特异度84.06%。在分辨TB和HC时,AUC为0.86,灵敏度74.14%,特异度82.61%。平行比较AFB、TB-DNA、GeneXpert、IGRAs、CD161检测方法的HIV-TB阳性率,分别为20%、40%、54.5%、38.1%和92.7%。当HIV-TB的CD4<100个/μL时上述5个检测技术的阳性率分别为26%、39.1%、60.8%、30.4%和82.6%。CD4≥100个/μL患者组检出率分别为15.6%、37.5%、50%、43.7%和100%。结论流式CD161技术在检测活动性结核及合并艾滋病中具有很好的临床诊断应用价值。Objective To study the clinical significance of flow CD161 in HIV with tuberculosis infection,and compare the differences between different detection methods.Methods The expression levels of CD161 in whole blood in 58 cases of tuberculosis patients(TB),55 cases of HIV-associated TB patients(HIV+TB),122 cases of AIDS(HIV)and 138 cases of healthy control(HC)were measured by flow assay.The positive rates of CD161,GeneXpert,TB-DNA,Interferon gamma release test(IGRAs)and AFB were compared.Results The expression levels of lymphocytes and CD161 in peripheral blood of TB were significantly lower than HC,while monocytes and OR values of TB were higher than HC,but were not affected by HIV infection.When the OR threshold was greater than 0.45,to distinguish between HC and TB-HIV,the AUC was 0.91,the sensitivity was 92.73%,and the specificity was 84.06%.To distinguish between TB and HC,the AUC was 0.86,the sensitivity was 74.14%,and the specificity was 82.61%.The positive rates of AFB,TB-DNA,GeneXpert,IGRAs and CD161 in HIV-TB were 20%,40%,54.5%,38.1%and 92.7%,respectively.When the CD4 count of HIV-TB was less than 100/μL,the positive rates of the above five detection techniques were 26%,39.1%,60.8%,30.4%and 82.6%,respectively.The detection rates of CD4≥100/μL patients were 15.6%,37.5%,50%,43.7%and 100%,respectively.Conclusions CD161 detected by flow cytometric can distinguish active tuberculosis and HIV co-infection.It could be useful to diagnosis of TB tuberculosis and HIV co-infection.

关 键 词：艾滋病合并结核病患者 CD161 GeneXpert Γ-干扰素释放试验 痰涂片 

分 类 号：R521.1[医药卫生—内科学]