重庆医学
重慶醫學
중경의학
Chongqing Medicine
2015年
28期
3928-3929,3932
,共3页
结核%病毒潜伏期%T-SPOT .TB%结核菌素皮肤试验%免疫抑制剂
結覈%病毒潛伏期%T-SPOT .TB%結覈菌素皮膚試驗%免疫抑製劑
결핵%병독잠복기%T-SPOT .TB%결핵균소피부시험%면역억제제
tuberculosis%virus latency%T-SPOT .TB%tuberculin skin test%immunosuppressive agents
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（P＜0．05）；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。
目的：探討 T‐SPOT ．TB 技術在潛伏結覈感染（LTBI）者免疫抑製劑治療中的篩查效果，為預防和控製 LTBI 提供新的依據。方法應用 T‐SPOT ．TB 試劑盒對162例需要應用免疫抑製的患者進行結覈分枝桿菌特異性 T 細胞的檢測；同時對所有病例做結覈菌素皮膚試驗（TST ）；對其中28例 T‐SPOT ．TB 技術篩查暘性患者應用抗 TNF‐α生物製劑治療前均給予預防性抗結覈藥物治療4箇月併隨訪1年。結果 T‐SPOT ．TB 暘性率為36．4％，確診率為94．9％；TST 暘性率為28．4％，確診率為69．6％。 T‐SPOT ．TB 暘性率和確診率與 TST 相比，差異有統計學意義（P＜0．05）；通過對28例 T‐SPOT ．TB 技術篩查暘性，給予預防性抗結覈藥物治療4箇月的患者1年的隨訪，結果無一例結覈病髮生。結論 T‐SPOT ．TB 技術在檢測 LTBI 敏感性彊、特異性高，是快速診斷結覈感染的有效手段；在應用免疫抑製劑對 LTBI 的篩查診斷中具有重要臨床價值。
목적：탐토 T‐SPOT ．TB 기술재잠복결핵감염（LTBI）자면역억제제치료중적사사효과，위예방화공제 LTBI 제공신적의거。방법응용 T‐SPOT ．TB 시제합대162례수요응용면역억제적환자진행결핵분지간균특이성 T 세포적검측；동시대소유병례주결핵균소피부시험（TST ）；대기중28례 T‐SPOT ．TB 기술사사양성환자응용항 TNF‐α생물제제치료전균급여예방성항결핵약물치료4개월병수방1년。결과 T‐SPOT ．TB 양성솔위36．4％，학진솔위94．9％；TST 양성솔위28．4％，학진솔위69．6％。 T‐SPOT ．TB 양성솔화학진솔여 TST 상비，차이유통계학의의（P＜0．05）；통과대28례 T‐SPOT ．TB 기술사사양성，급여예방성항결핵약물치료4개월적환자1년적수방，결과무일례결핵병발생。결론 T‐SPOT ．TB 기술재검측 LTBI 민감성강、특이성고，시쾌속진단결핵감염적유효수단；재응용면역억제제대 LTBI 적사사진단중구유중요림상개치。
Objective To explore the T‐SPOT .TB technology in latent tuberculosis infection (LTBI) who immunosuppres‐sive therapy results in screening for latent tuberculosis infection prevention and control to provide a new basis .Methods Applica‐tion of T‐SPOT .TB kit 162 immunosuppressed patients need to be applied to detect M .tuberculosis‐specific T cells ;while doing all cases tuberculin (TST ) skin test ;of which 28 cases of T‐SPOT .TB‐positive patients before screening technique using anti‐TNF‐αbiologics were given prophylactic treatment of anti‐TB drugs for 4 months and followed a year .Results The positive rates and ac‐curacy rate of T‐SPOT .TB assay were 36 .4% and 94 .9% ,while the positive rates and accuracy rate of TSTs were 28 .4% and 69 .6% .The difference between T‐SPOT .TB assay and TST were statistical significance(P < 0 .05) .Through our 28 cases of T‐SPOT .TB positive screening technology ,prophylactic anti‐TB drugs to treat patients for 4 months and 1 year of follow‐up ,no case of tuberculosis occurred .Conclusion These results demonstrate that the performance of T‐SPOT .TB is better than the classic TST for detection of LTBI in patients receiving immunosuppressive therapy for treatment of systemic autoimmune disorders .The T‐SPOT .TB assay will be a useful tool in early and rapid diagnosis of latent tuberculosis infection .T‐SPOT .TB for LTBI patients di‐agnosed with prophylactic anti‐TB drug treatment is necessary ,has important clinical significance .
