T-SPOT.TB在结核性脊柱炎疗效评价中的作用

目的 探讨结核感染T细胞试验 (T-SPOT.TB) 中两种抗原ESAT-6及CFP-10在评价结核性脊柱炎治疗效果中的价值.方法 回顾性分析2013年1月至2016年1月就诊于昆明医科大学第一附属医院、T-SPOT.TB (+) , 初治且明确诊断为结核性脊柱炎并随访成功共29例.应用Wilcoxon秩合检验及χ2检验分析ESAT-6及CFP-10在结核性脊柱炎疗效过程中变化.并绘制ESR、CRP、VAS与ESAT-6及CFP-10的散点图进行线性回归分析.结果 ESAT-6及CFP-10治疗前的斑点计数分别与治疗后6个月、12个月及治愈后的斑点计数比较, 治疗6个月时, 斑点计数下降无统计学意义, 治疗12个月及治愈后斑点计数较治疗前明显下降, P<0.05, 差异有统计学意义.CFP-10治疗前的阳性结果分别与治疗后3次随访阳性结果进行χ2检验, 治疗前、治疗后6个月、12个月及治愈后阳性率分别为86.20%、86.20%、75.86%、58.62%, P<0.05, 差异有统计学意义.ESAT-6仅与VAS呈线性相关, 而CFP-10与VAS、ESR均呈线性相关关系, 但是相关性均较弱.结论 ESAT-6及CFP-10的斑点计数下降提示治疗有效, 且CFP-10可能成为评价治疗效果的指标之一.

The Value of T-SPOT.TB in Evaluating Treatment Effect of Tuberculous Vertebral Osteomyelitis

Objective To investigate the treatment evaluating value of ESAT-6 and CFP-10 in T-SPOT.TB kit for tuberculous vertebral osteomyelitis.Me dthods This retrospective study analyzed 29 cases diagnosed as TVO in the First Affiliated Hospital of Kunming Medical University from January 2013 to January 2016. All cases were the first-time consultancy. The Wilcoxon-singed-rank-test and chi-square test were used to analyze the changes of ESAT-6 and CFP-10 in the procedure of treatment. The linear-regression analysis was used to analyze the relationship between ESR, CRP, VAS and two specific antigens.Re s ults The pretherapeutic spot counts of ESAT-6 and CFP-10 were compared with the first and the last follow-up respectively. The results of two antigenic spots change showed a higher consistency (P<0.05) .The positive rates of CFP-10 at the prior treatment, the first follow-up and the last follow-up were 86.20%, 79.31% and 58.62% respectively. The result of chi-square test showed a higher consistency (P <0.05) . ESAT-6 only correlated with VAS. CFP-10 had the relationship with VAS and ESR. But all of these relativities were weak.Conclus ion The decrease in the spot counts of ESAT-6 and CFP-10 suggest that the treatment is effective, and CFP-10 may be one available index to evaluate the treatment effect.