结核感染T细胞斑点试验对结核病治疗效果的监测价值

目的：探讨结核感染T细胞斑点试验对结核病治疗疗效的监测意义。方法本研究采用T-SPOT.TB试剂盒，检测T细胞中γ-干扰素对结核分支杆菌特异性多肽类早期分泌性抗原靶标6-kD(ESAT-6)和培养滤液蛋白(CFP-10)的应答，对比113例结核感染者治疗前与治疗后T-SPOT.TB结果的变化，其结果根据对该试验中两种抗原的联合与各自应答来分析。结果113例感染者在治疗后T-SPOT.TB结果转阴者有42例(37.2%)。其中，CFP-10转阴率占48.9%(P<0.001)，ESAT-6转阴率占20.0%(P=0.238)。ESAT-6的斑点形成细胞(SFCs)/2.5×105外周血单核细胞(PBMCs)的平均数在治疗前和治疗后分别为18.47和16.29(P=0.16)，而CFP-10的SFCs/PBMCs的平均数在治疗前和治疗后分别为22.83和15.31(P<0.01)。结论结核病治疗对于T细胞中γ-干扰素引起的ESAT-6和CFP-10抗原应答影响不同，CFP-10的定量应答才是结核病治疗的更有效监测手段。

Value of T-SPOT.TB assay on monitoring the tuberculosis treatment efficacy

Objective To explore the value of T-SPOT.TB assay on monitoring the tuberculosis treatment efficacy. Methods We used the T-SPOT.TB assay to measure T-cell interferon-γresponses to Mycobacterium tuber-culosis-specific peptides early secretory antigenic target 6-kD protein (ESAT-6) and culture filtrate protein 10 (CFP-10) in 113 patients with tuberculosis before and after the treatment. The results of changes in T-SPOT.TB be-fore and after the treatment were analyzed according to the combined and separate responses to ESAT-6 and CFP-10 antigens. Results When the treatment was completed, 42 (37.2%) of 113 patients with tuberculosis reverted to negative according to the T-SPOT.TB results, of which CFP-10 reversion rate was 48.9%(P<0.001), and the ESAT-6 reversion rate was 20.0%(P=0.238). The mean number of spot-forming cells (SFCs)/2.5×105 peripheral blood mononucle-ar cells (PBMCs) pre-and post-treatment were respectively 18.47 versus 16.29 for ESAT-6 (P=0.16) and 22.83 versus 15.31 for CFP-10 (P<0.01). Conclusion Tuberculosis treatment has a differential effect on T-cell responses to ESAT-6 and CFP-10 as measured by T-SPOT.TB. The quantitative response to CFP-10 may be a more useful monitoring tool for treatment efficacy.