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T-SPOT.TB在结核病诊断中的应用价值

刘国威1,梅早仙1,杜钟珍2   

  1. 1. 天津市海河医院
    2. 天津海河医院
  • 收稿日期:2011-09-09 修回日期:2012-03-06 出版日期:2012-09-15 发布日期:2012-09-15
  • 通讯作者: 刘国威

The in-vitro Interferon-Gamma Release Assay T-SPOT.TB for the Diagnosis of Tuberculosis

wei Guo LIU 2,   

  • Received:2011-09-09 Revised:2012-03-06 Published:2012-09-15 Online:2012-09-15
  • Contact: wei Guo LIU

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摘要： 【摘要】 目的 评价γ-干扰素释放试验(IGRA)T-SPOT.TB在结核病诊断中的应用价值。方法 获取肺结核患者（肺结核组，36例）、肺外结核患者（肺外结核组，18例）和健康人（健康对照组，31例）外周血单个核细胞（PBMC）。利用结核分枝杆菌特异抗原ESAT-6 和and CFP-10与PBMC共同培养，采用酶联免疫斑点法检测培养液中γ-干扰素浓度。比较T-SPOT.TB与TST及相关指标TB-AB、ESR、ADA等的结果。结果 T-SPOT.TB在结核病中的敏感性是92.6%，肺结核组、肺外结核组T-SPOT.TB阳性率均高于健康对照组，差异有统计学意义（P＜0.05），肺结核组和肺外结核组之间并没有差异性（P＞0.05）。各组间TST阳性率无显著性差异（P＞0.05）。在健康对照组中，T-SPOT.TB特异性(93.5%)高于TST(54.8%)，结果有显著性差异（P＞0.05）。肺结核组、肺外结核组TB-AB，ESR，ADA水平均高于健康对照组，差异有统计学意义（P＜0.05）。结论 T-SPOT.TB对结核病诊断特异性高，优于TST试验，其联合TB-AB、ESR、ADA等对于结核病的诊断意义更大。

关键词: γ-干扰素, 释放试验, T-SPOT.TB, 结核

Abstract: 【Abstract】 Objective To evaluate the in-vitro Interferon-Gamma Release Assay T-SPOT.TB for the Diagnosis of Tuberculosis . Methods The peripheral blood mononuclear cells(PBMC) were collected from the patients with tuberculosis(tuberculosis group,n=36) ,patients with extrapulmonary tuberculosis,( extrapulmonary tuberculosis group,n=18),and healthy controls(healthy control group,n=31).The PBMCs were co-cultured with different antigens: ESAT-6 and CFP-10.The levels of interferon-Gamma were detected by ELISPOT ,and the results were compared to those with tuberculin skin test(TST)、TB-AB、ESR and ADA. Results The T-SPOT.TB assay showed positive results in 46 patients with tuberculosis and the sensitivity was 92.6%. There was significant difference of the T-SPOT.TB results in patients with tuberculosis and healthy controls, and the same in patients with extrapulmonary tuberculosis and healthy controls（P＜0.05）. There was no significant difference of the T-SPOT.TB results in patients with tuberculosis and patients with extrapulmonary tuberculosis（P＞0.05）. There was no significant difference of the TST results among the three groups(P＞0.05).The specificity of T-SPOT.TB(93.5%) was higher than TST(54.8%) in healthy controls, the difference was significant（P＜0.05）. The levels of TB-AB、ESR and ADA was higher in patients with tuberculosis and patients with extrapulmonary tuberculosis than in healthy controls, the difference was significant（P＜0.05）.Conclusions The T-SPOT.TB has highly specificity in diagnosis of tuberculosis and is better than TST. the significance is higher if combined T-SPOT.TB with TB-AB、ESR and ADA .

Key words: interferon-Gamma, release assay, T-SPOT.TB, Tuberculosis