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酶联免疫斑点法检测肺结核患者特异性结核抗原多肽T细胞的应答 被引量:5

Evaluation of enzyme-linked immunospot assay detecting Mycobacterium tuberculosis specific T cell responses in patients with pulmonary tuberculosis
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摘要 目的评价我国酶联免疫斑点法(ELISPOT)用于诊断肺结核患者的应用价值。方法结核特异性ELISPOT法检测76例诊断明确的肺结核患者外周血单核细胞。同时选择30例无结核接触史、胸部X线片无异常且PPD皮试阴性的成年人作为对照。数据采用卡方检验和非参数Mann—Whitney检验。结果76例患者总体阳性率为71.0%,健康对照组阳性率为6.7%。按照患者抗结核疗程分为治疗1个月内、治疗6个月内、治疗6个月以上3组,阳性率分别为87.5%、74.1%和52.0%(x^2=35.63,P=0.000)。该技术在初冶结核患者中的灵敏度为87.5%,特异度为93.3%,阳性预测值为91.3%,阴性预测值为90.3%。结论结核特异性ELISPOT技术在我国初治(抗结核化疗疗程1个月内)的结核病患者中具有较高诊断价值。 Objective To evaluate the application of a new enzyme linked immunospot assay (ELSIPOT) based on Mycobacterium tuberculosis-sepcific T cells detection in the diagnosis of active pulmonary tuberculosis in China. Methods Using the ELISPOT assay, T cells specific for early secreted antigenic target 6-kDa protein (ESAT 6) and culture filtrate protein 10 (CFP-10) in the peripheral blood from 76 active pulmonary tuberculosis patients were measured. Thirty healthy people were recruited as healthy controls, which had no tuberculosis contacting history and were normal for chest X ray examination as well as negative for tuberculosis skin test (TST). The data were analyzed using Chi-square test and Mann-Whitney test. Results The positive rate of ELISPOT was71. 0% (54/76) and 6. 7% (2/30) in the patients with active pulmonary tuberculosis and healthy controls respectively. Furthermore, the positive rate was as high as 87.5 % in patients with antituberculosis treatment course less than 1 month, and decreased to 74.1 % and 52.0% in the patients with the treatment course varying from 1 to 6 months and more than 6 months respectively(x^2= 35. 63, P= 0. 000). In the patients with treatment course less than 1 month, the sensitivity, specificity, positive predictive value and negative predictive value of ELISPOT were 87.5 %, 93.3%, 91.3% and 90.3%, respectively. Conclusion ELISPOT assay is a sensitive assay for detecting tuberculosis infection, especially in the patients with anti-tuberculosis treatment course less than 1 month.
出处 《中华传染病杂志》 CAS CSCD 北大核心 2008年第8期467-470,共4页 Chinese Journal of Infectious Diseases
基金 国家自然科学基金资助项目(30400369)
关键词 结核 酶联免疫斑点法 T淋巴细胞 抗原 细菌 Tuberculosis, pulmonary Enzyme linked immunospot assay T lymphocytes Antigen, bacterial
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参考文献7

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同被引文献41

  • 1乐军,梁莉,李苏辉,张跃建,肖和平.酶联免疫斑点试验快速诊断结核分枝杆菌感染的临床应用价值[J].中华检验医学杂志,2006,29(11):1005-1008. 被引量:70
  • 2朱威,王娜.腮腺结核57例临床分析[J].口腔医学研究,2007,23(1):88-88. 被引量:12
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  • 6Lalbani A. Spotting latent infection: the path to better tuberculosis control. Thorax, 2003, 58: 916-918.
  • 7Imaizumi K, Sugishita M, Usui M, et al. Pulmonary infectious complications associated with anti-TNF alpha therapy (infliximab) for rheumatoid arthritis. Intern Med, 2006, 45: 685-688.
  • 8Keane J, Gershon S, Wise RP, et al. Tuberculosis associated with infliximab, a tumor necrosis factor alpha-neutralizing agent. N Engl J Med, 2001, 345: 1098-1104.
  • 9Philip C, Dolly JS, Annette F, et al. ESAT-6/CFP-IO fusion protein and peptides for optimal diagnosis of mycobacterium tuberculosis infection by ex vivo enzyme-linked immunospot asssay in the gambia. J Clin Microbiol, 2005, 43: 2070-2074.
  • 10Lalvani A, Pathan AA, McShane H, et al. Rapid detection of Mycobacterium tuberculosis infection by enumeration of antigenspecific T cells. Am J Respir Crit Care Med, 2001, 163: 824-828.

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