T-SPOT.TB技术在潜伏结核感染者免疫抑制剂治疗中的临床应用

发布时间：2018-04-04 22:34

本文选题：结核　切入点：病毒潜伏期　出处：《重庆医学》2015年28期

【摘要】：目的探讨T-SPOT.TB技术在潜伏结核感染(LTBI)者免疫抑制剂治疗中的筛查效果,为预防和控制LTBI提供新的依据。方法应用T-SPOT.TB试剂盒对162例需要应用免疫抑制的患者进行结核分枝杆菌特异性T细胞的检测;同时对所有病例做结核菌素皮肤试验(TST);对其中28例T-SPOT.TB技术筛查阳性患者应用抗TNF-α生物制剂治疗前均给予预防性抗结核药物治疗4个月并随访1年。结果 T-SPOT.TB阳性率为36.4%,确诊率为94.9%;TST阳性率为28.4%,确诊率为69.6%。T-SPOT.TB阳性率和确诊率与TST相比,差异有统计学意义(P0.05);通过对28例T-SPOT.TB技术筛查阳性,给予预防性抗结核药物治疗4个月的患者1年的随访,结果无一例结核病发生。结论 T-SPOT.TB技术在检测LTBI敏感性强、特异性高,是快速诊断结核感染的有效手段;在应用免疫抑制剂对LTBI的筛查诊断中具有重要临床价值。
[Abstract]:Objective to investigate the screening effect of T-SPOT.TB in immunosuppressive therapy for patients with latent tuberculosis infection (LTBI), and to provide a new basis for the prevention and control of LTBI.Methods Mycobacterium tuberculosis specific T cells were detected by T-SPOT.TB kit in 162 patients who needed immunosuppression.All the patients were treated with tuberculin skin test and 28 patients with positive screening by T-SPOT.TB technique were treated with prophylactic antituberculous drugs for 4 months and followed up for 1 year.Results the positive rate of T-SPOT.TB was 36.4%, the positive rate of TST was 94.9% and the positive rate of 69.6%.T-SPOT.TB was 28.4%. Compared with TST, the positive rate of T-SPOT.TB was significantly higher than that of TST.None of the patients who were treated with prophylactic antituberculous drugs for 4 months were followed up for 1 year.Conclusion T-SPOT.TB is an effective method for the rapid diagnosis of tuberculosis infection and has important clinical value in the screening and diagnosis of LTBI by using immunosuppressive agents because of its high sensitivity and specificity in the detection of LTBI.
【作者单位】：潍坊医学院/山东省临床检验诊断学高校重点实验室;
【基金】：国家自然科学基金资助项目(81100006) 山东省自然科学基金资助项目(ZR2010HM073)
【分类号】：R52;R446.6

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