酶联免疫斑点法在快速诊断活动性肺结核中的应用

目的探讨酶联免疫斑点法（ELISPOT）在临床快速诊断活动性肺结核病中的应用价值。方法：采用T—SPOT．TB试剂盒对36例明确诊断为活动性肺结核的初治患者、30例健康体检者的外周血中结核分枝杆菌特异性T淋巴细胞进行检测，同时对26例活动性肺结核患者做结核菌素（PPD）试验。结果在36例活动性肺结核初治患者和30例健康对照者中，T-SPOT检测的阳性率分别为80．6％与6．7％，此技术用于诊断初治活动性肺结核患者的敏感性为80．6％，特异性为93．3％，阳性预测值为93．5％，阴性预测值为80．0％。在26例同时做PPD试验的活动性肺结核患者中，T-SPOT检测的阳性率略高于PPD试验（80．6％vs61．5％），但差异无明显统计学意义（P〉0．05）。结论酶联免疫斑点法是一种具有较高敏感性和特异性的检测结核感染的技术，在活动性肺结核病的快速诊断中有较大应用价值。

Clinical application of enzyme-linked immunospot assay for rapid detection of active pulmonary tuberculosis infection

Objective To evaluate the clinical application of enzyme-linked immunospet （ELIS- POT） assay for rapid detection of active pulmonary tuberculosis. Methods Rapid T-SPOT. TB assay was employed to detect Mycobacterium tuberculosis antigen specific T cells in blood samples from 36 patients with active pulmonary tuberculosis receiving initial anti-tuberculosis treatment shorter than 1 month and 30 healthy individuals. The conventional PPD skin test was performed on 26 patients with active tuberculosis at the same time. Results By the T-SPOT. TB assay, positive rates for the 36 patients with active tuberculosis and 30 healthy controls were 80.6% and 6. 7%, respectively. For diagnosing active pulmonary tuberculosis, this assay had a sensitivity of 80.6%, specificity of 93.3%, positive predictive value of 93.5% and negative predictive value of 80.0%. The positive rate of T-SPOT. TB assay was higher than that of PPD skin test in 26 patients （80.6% vs 61.5% ）, but no significant difference was found （P 〉 0.05 ）. Conclusions T- SPOT. TB assay is a rapid, more sensitive and specific method for detecting Mycobacterium tuberculosis infection. It will be a useful tool to early and rapidly diagnose active pulmonary tuberculosis infection in China.