摘要
目的探讨T细胞酶联免疫斑点法(TSPOT)在我国人类免疫缺陷病毒(HIV)感染人群中用于诊断结核潜伏感染的应用价值。方法应用TSPOT-TB试剂盒对68例明确诊断的HIV感染者血液标本进行结核分枝杆菌(Mtb)特异性T细胞的检测,同时对所有病例做结核菌素纯蛋白生物(PPD)试验。结果在HIV感染者总体、CD4<200/μl和CD4>200/μl各组中,TSPOT检测阳性率分别为67.65%、44.44%和70.69%,PPD试验阳性率分别为41.18%、11.11%和46.55%,其中在HIV感染者总体及CD4>200/μl组中TSPOT检测阳性率均高于PPD试验,差异有统计学意义(P均<0.005)。TSPOT检测在CD4<200/μl组中的阳性率低于CD4>200/μl组,但差异无统计学意义(P>0.05);PPD试验在CD4<200/μl组中的阳性率远低于CD4>200/μl组,差异有统计学意义(P<0.05)。结论TSPOT检测在我国HIV感染合并结核潜伏感染的早期快速诊断中有较大应用价值,尤其是在CD4细胞计数>200/μl的HIV感染人群中,阳性率高于目前常用的PPD试验。PPD试验阳性率受CD4细胞计数水平的显著影响,而TSPOT检测不受此因素影响。
Objective To evaluate the application of a new enzyme-hnked immunospot assay （T SPOT-TB） in diagnosing latent tuberculosis （TB） infection in HIV-positive individuals in China. Methods The rapid T SPOT-TB assay was employed to detect ESAT-6- and CFP- 10-specific T cells in blood samples from 68 HIV-positive individuals. A PPD skin test was performed on all patients as a positive control. Results Using the T SPOT-TB assay, positivity rates for the 68 HIV-positive individuals, 9 HIV-positive individuals with CD4 cell counts less than 200/μl and 58 HIV-positive individuals with CD4 cell counts greater than 200μl were 67.65%, 44.44% and 70.69%, respectively. The positive rates of the PPD skin test were 41.18%, 11.11% and 46.55% in these three groups, respectively. These results indicate that the positive rates obtained from the use of the T SPOT-TB assay were significantly higher than those obtained from the PPD skin test for the HIV-positive individuals included in the current study, including those with CD4 cell counts greater than 200μ （ P 〈 0.005）. The positivity rate oobtained from the T SPOT-TB assay was not significantly affected by the patients＇ CD4 cell count （P 〉 0.05）. In contrast, the positive rate obtained through the PPD skin test was significantly decreased in HIV-positive individuals with CD4 cell counts less than 200μl （ P 〈 0. 05）. Conclusion The T SPOT-TB assay appears to be better in detecting TB in HIV-positive individuals with latent tuberculosis infection in China when compared to the conventional PPD skin test, particularly in those individuals with CD4 cell counts greater than 200/μl. Furthermore, the ability of the T SPOT-TB assay to detect latent TB in HIV-infected patients is independent of CD4 cell count while the positive rate of PPD skin test can be significantly influenced by the CD4 cell count. The T SPOT-TB assay will be a useful tool in early and rapid diagnosis of latent tuberculosis infection in HIV-positive individuals in China.
出处
《微生物与感染》
2007年第3期132-137,共6页
Journal of Microbes and Infections
基金
国家重点基础研究发展计划(973计划)(2005CB523102)
关键词
人类免疫缺陷病毒
结核分枝杆菌
潜伏感染
酶联免疫斑点技术
结核菌素试验
Human immunodeficiency virus
Mycobacterium tuberculosis
Latent infection
Enzyme-linked immunospot assay
Tuberculin skin testing
