摘要
目的探讨肺结核活动程度对结核感染T细胞斑点试验反应强度的影响。方法选取2018年6月至12月期间在昆明市第三人民医院结核二科400例活动性肺结核患者,所有患者均进行了结核感染T细胞斑点试验(T-SPOT.TB),对比分析活动性肺结核患者,在不同病情状态下,T-SPOT.TB的免疫强度。结果180例病原学阳性肺结核,T-SPOT.TB阳性率为96.1%(173/180);220例病原学阴性肺结核,T-SPOT.TB阳性率86.4%(190/220),两者χ2检验比较差异有统计学意义(χ2=11.205,P=0.001<0.05);两组中抗原ESAT-6阳性率比较差异有统计学意义(χ2=12.753,P=0.000<0.05),抗原CFP-10阳性率比较差异无统计学意义(χ2=2.482,P=0.115>0.05)。病原学阳性且T-SPOT.TB阳性173例肺结核患者中,按照抗酸杆菌涂片量(1条~1+、2+、3+、4+)进行分组比较,4组抗原ESAT-6、CFP-10进行比较,差异无统计学意义(P=0.792,0.595,均>0.05);按治疗史分为初治、复治肺结核,两组间抗原ESAT-6、CFP-10比较,其中抗原ESAT-6在初、复治肺结核比较中有统计学差异(Z=-2.178 P=0.005<0.05),抗原CFP-10比较无统计学差异(Z=-0.856,P=0.392>0.05);按照耐药状况分非耐药、耐药肺结核,两组间抗原ESAT-6、CFP-10比较无统计学差异(P=0.748,0.845,均>0.05)。结论结核感染T细胞斑点试验对诊断活动性肺结核的敏感性较好,利用其应答强度反映结核感染活动程度有一定临床意义。
Objective To investigate the effect of the activity of tuberculosis on the response intensity of T cell spot test for tuberculosis infection(T-SPOT.TB).Methods From June to December 2018,400 patients with active tuberculosis receiving T-SPOT.TB in the No.2 Department of Tuberculosis in theThird People's Hospital of Kunming were selected.The immunization intensity of T-SPOT.TB in patients with active tuberculosis was comparatively analyzed under the different conditions.Results A total of 180 patients showed pathogenic positive tuberculosis,with the positive rate of T-SPOT.TB being 96.1%(173/180),and the other 220 patients had pathogenic negative tuberculosis,with the positive rate of T-SPOT.TB being 86.4%(190/220),presenting a statistical difference by the Chi-square test(χ2=11.205,P=0.001<0.05).A statistical difference was found in the positive rate of antigen ESAT-6 between the two groups(χ2=12.753,P=0.000<0.05),but not in the positive rate of antigen CFP-10(χ2=2.482,P=0.115>0.05).Among 173 patients with pathogenic positive and T-SPOT.TB-positive tuberculosis,antigens ESAT-6 and CFP-10 showed no statistical differences based on the amount of acid-fast bacilli smear(1~1+,2+,3+and 4+)(P=0.792 and 0.595,both P>0.05).According to the history of treatment,the patients were divided into both the primary treatment and retreatment groups.A statistical difference was found in ESAT-6(Z=-2.178,P=0.005<0.05)but not in CFP-10(Z=-0.856,P=0.392>0.05)between the primary treatment and retreatment groups.ESAT-6 and CFP-10 demonstrated no statistical differences between the patients with non-drug-resistant and drug-resistant tuberculosis(P=0.748 and 0.845,both>0.05).Conclusion The sensitivity of T-SPOT.TB in the diagnosis of active tuberculosis is high.It is of certain clinical significance to use its response intensity to reflect the activity of tuberculosis infection.
作者
万荣
李明武
李光妹
朱惠琼
马萌
刘才
WAN Rong;LI Ming-wu;LI Guang-mei;ZHU Hui-qiong;MA Meng;LIU Cai(Dept.of Tuberculosis,The Third People's Hospitalof Kunming,Kunming Yunnan 650041,China)
出处
《昆明医科大学学报》
CAS
2020年第9期102-106,共5页
Journal of Kunming Medical University
基金
昆明市卫计委医药卫生科技计划项目(2018-03-08-003)。
