结核γ-干扰素酶联免疫斑点检测在结核性心包积液诊断中的应用

目的 探讨结核菌特异性γ-干扰素（interferon-gamma,IFN-γ）酶联免疫斑点（enzyme-linked immunosorbent spot,ELISPOT）检测对结核性心包积液的诊断价值.方法 采用结核菌特异性IFN-γ ELISPOT技术同时检测20例结核性心包积液患者（TP组）和14例非结核性心包积液患者（Non-TP组）外周血单核细胞（peripheral blood mononuclear cells,PBMC）及心包积液单核细胞（pleural effusion mononuclear cells,PEMC）中结核菌特异性IFN-γ水平.结果 TP组PBMC和PEMC结核菌特异性IFN-γ水平均显著高于Non-TP组,差异有统计学意义（P＜0.01,P＜0.01）.TP组心包积液中结核菌特异性IFN-y水平显著高于外周血IFN-γ水平,差异有统计学意义（P＜0.01,P＜0.01）.PBMC ELISPOT检测结核性心包积液的敏感性和特异性分别为80.0％和85.7％;而PEMC ELISPOT敏感性和特异性为90.0％和85.7％.结论 结核菌特异性IFN-γELISPOT技术对结核性心包积液诊断和鉴别诊断具有很好的辅助价值.

Utility of interferon-gamma enzyme-linked immunosorbent spot assay in the diagnosis of tuberculous pericardial effusion

Objectives To observe the clinical utility of the mycobacterium tuberculosis antigen-specific interferon-gamma （IFN-γ） enzyme-linked immunosorbent spot （ELISPOT） assay in the diagnosis of tuberculous pericardial effusion.Methods IFN-γELISPOT assay was used to determine the mycobacterium tuberculosis antigen-specific IFN-γ productions of peripheral blood mononuclear cells （PBMCs） and pleural effusion mononuclear cells （PEMCs） in 20 patients with tuberculous pericardial effusion （TP group） and 14 patients with non-tuberculous pericardial effusion （Non-TP group）.Results The productions of antigen-specific IFN-γin PBMCs and in PEMCs of tuberculous pericardial effusion patients were significantly higher than those of non-tuberculous pericardial effusion patients （P〈0.01,P〈0.01）.The production of antigen-specific IFN-γin PEMCs was much more higher than that in PBMCs of tuberculous pericardial effusion patients （P〈0.01,P〈0.01）.The sensitivity and specificity of ELISPOT assay in PBMCs and PEMCs were 80.0%,85.7% and 90.0%,85.7% respectively.Conclusions Mycobacterium tuberculosis antigen-specific IFN-γ ELISPOT assay is useful in improving the diagnosis of tuberculous pericardial effusion.