酶联免疫斑点法检测结核性胸水T淋巴细胞分泌IFN-γ的免疫功能

目的:研究结核性胸膜炎患者胸水T淋巴细胞(TLC)特异性分泌γ-干扰素(IFN-γ)的免疫反应,为结核性胸水的诊断提供依据。方法:应用淋巴细胞分离技术分离13例结核性胸水和11例恶性胸水TLC,体外利用PPD抗原刺激,用酶联免疫斑点法(ELISPOT)检测两组胸水TLC分泌IFN-γ的免疫反应。每例患者院内常规做PPD试验。结果:结核性胸水TLC分泌IFN-γ的免疫反应阳性率为84.62%(11/13例),明显高于恶性胸水组18.18%(2/11例),两者之间差异有显著性(P<0.01)。ELISPOT和PPD试验的敏感性分别为84.62%,46.15%,两者之间有明显差异性(P<0.01)。而ELISPOT和PPD试验的特异性分别为81.82%,90.91%,两者之间差异不明显。结论:ELISPOT检测结核性胸膜炎的敏感性和特异性均较高,有助于临床上对结核性胸水的鉴别诊断。

T-Lymphocytes Immune Function of IFN-Gamma Production from Tuberculous Pleural Effusions Assayed by ELISPOT

Objective: To investigate the tuberculous specific interferon-gamma(IFN-γ) production of T-lymphocytes(TLCs) from Pleural effusion of tuberculosis and its significance for diagnosis.Methods: TLCs in tuberculous pleural(n=13) and malignant(n=11) effusions were obtained by lymphocyte isolate technique,and stimulated with PPD antigen in vitro.The production of IFN-γ was measured by enzyme link immunospot(ELISPOT).Each patient adopted the PPD test in hospital routinely.Results: The positive responsive rate of IFN-γ production by TLCs from tuberculous pleural effusions was 84.62%(11/13),and was significantly higher than 18.18%(2/11)(P<0.01) from malignant ones.The sensitivity of ELISPOT was 84.62% and higher than 46.15% of PPD test(P<0.01).But the specificity of ELISPOT was 81.82% and was not significantly different from that of PPD test 90.91%(P>0.05).Conclusion: ELISPOT can help differential diagnosis of tuberculous pleural effusions for its higher sensitivity and specificity.