摘要
目的评价早期建立的结核菌特异性IFN-γ Elispot检测在活动性结核病和结核感染诊断中的应用价值。方法应用Elispot技术对1 154例结核病患者,52例非结核病肺部疾病对照,384例新发痰菌阳性结核患者的密切接触者,422例健康对照进行外周血结核菌特异性IFN-γ水平检测。对健康对照和密切接触者同时还进行平行的PPD皮试。结果结核患者Elispot检测的阳性率显著高于对照人群及结核病密切接触者。其中,血行播散性结核、继发性肺结核、结核性胸膜炎、结核性脑膜炎和其他肺外结核患者Elispot阳性率分别为91.3%,81.7%,86.5%,66.2%,89.8%。非结核病肺部疾病对照、健康对照和新发结核病人密切接触者Elispot阳性率分别为13.5%,15.4%和35.4%。在密切接触者筛查中,发现活动性结核病人17例,其中Elispot阳性14例(82.4%),PPD强阳性5人(29.4%);两者阳性率差异有统计学意义。结论在结合结核病史、结核病接触史以及临床表现的基础上,结核菌特异性IFN-γ的检测对活动性结核病诊断有一定的辅助诊断价值。通过检测结核高危人群结核菌特异性IFN-γ的水平,对早期发现活动性结核患者具有重要的价值。
Objective To appraise the clinical utility of an in-house interferon-γ Elispot assay for the diagnosis of active tuberculosis. Methods A in-house Elispot assay was used to determine Mycobacterium tuberculosis antigen-specific IFN-γ production in 1154 patients with active tuberculosis, 52 case controls with non-tuberculosis lung diseases, 422 healthy controls and 384 close contacts with newly diagnosed active tuberculosis patients. PPD skin test was used in parallel with Elispot in some healthy controls and close contacts. Results The positive rate of Elispot assay was significantly higher in the patients with tuberculosis than controls. In particular, 91.3% of patients with acute hematogenous disseminated tuberculosis, 81.7% of patients with secondary pulmonary tuberculosis, 86.5% of patients with tuberculous pleurisy, 66.2% of patients-with tuber-culous meningitis, and 89.8% of patients with extra-pulmonary tuberculosis were positive for IFN-γ Elispot assay. In comparison, the positive rates of Elispot assay in case controls, healthy controls and close contacts were 13.5%,15.4% and 35.4%, respectively. Seventeen individuals out of 384 close contacts were diagnosed with active tuberculosis. The positive rate （82.4%） of Elispot in these subjects was significantly than 20 mm. Conclusion Co exposure to tuberculosis and cli sis of active tuberculosis. nlc higher than that of PPD skin test （29.4%） with induration over ined with the information related to tuberculosis history, recent al manifestation, Elispot assay can be used to improve the diagno sis of active tuberculosis.
出处
《中国防痨杂志》
CAS
2010年第11期747-751,共5页
Chinese Journal of Antituberculosis
基金
国家自然科学基金资助项目(30872258)
国家十一五科技重大专项"艾滋病和病毒性肝炎等重大传染病防治"专题项目(2008ZX10003-005)
关键词
结核/诊断
干扰素Ⅱ型
免疫敏技术
tuberculosis/diagnosis
interferon-γ
immunoenzyme techniques
