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首页> 中文期刊> 《中国感染控制杂志》 >应用酶联免疫斑点试验检测入伍新兵结核潜伏感染

应用酶联免疫斑点试验检测入伍新兵结核潜伏感染

         
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Objective To study the latent tuberculosis infection (LTBI) in the new recruits with enzyme-linked immunospot assay (ELISPOT), and evaluate the value of ELISPOT on the detection of LTBI. Methods A total of 366 new recruits were intradermally injected with purified protein derivative (PPD) , and detected with ELISPOT assay with recombinant CFP-10/ESAT-6 fusion protein (rCFP-10/ESAT-6) as a stimulus. New recruits who were ELISPOT- and PPD-negative were vaccinated by intradermal injection with Bacillus Calmette-Guerin (BCG) vaccine, they were detected by PPD skin test and ELISPOT assay again 10 months later. Results Among 366 new recruits , the positive rate of PPD skin test and ELISPOT assay was 44. 81 % and 31. 69%, respectively. Of 202 PPD-negative and 164 PPD-positive new recruits, 53 (26. 24%) and 63 (38. 41%) were ELISPOT positive, respectively, overall consistency between two tests was 57. 92% (212/366), the difference was statistically significant(χ2 = 14. 34,P<0. 001). Among new recruits with BCG vaccination , PPD- and ELISPOT-positive rate was 58. 53% (127/217) and 29. 03% (63/217) respectively, spot forming cell (SFC) were 32. 44 ± 26. 52; Among new recruits without BCG vaccination , PPD- and ELISPOT-positive rate was 24. 83% (37/149) and 35. 57% (53/149) respectively, SFC were 41. 81 ± 30. 48. 78. 18% of 110 new recruits vaccinated by BCG vaccine 10 months later were PPD-positive, but all of they were ELISPOT-negative. Conclusion ELISPOT technique has high specificity and sensitivity for screening TB infection.%目的 应用酶联免疫斑点试验(ELISPOT)检测入伍新兵结核潜伏感染情况,评价ELISPOT在检测结核潜伏感染中的价值.方法 以结核菌素纯蛋白衍生物(PPD)皮肤试验为对照,应用ELISPOT试剂盒检测366例2009年驻京部队入伍新兵外周血中分泌结核菌抗原特异性γ干扰素(IFN-y)的T淋巴细胞数.对PPD和ELISPOT均为阴性的入伍新兵接种卡介苗,10个月后再做PPD皮肤试验和ELISPOT,比较结果.结果 366例入伍新兵中,PPD皮肤试验和ELISPOT阳性率分别为44.81%和31.69%.202例PPD皮肤试验阴性和164例PPD皮肤试验阳性者中,分别有53例(26.24%)和63例(38.41%) ELISPOT阳性,两者的一致率为57.92%(212/366),两者的检测结果差异具有统计学意义(x2=14.34,P＜0.001).在接种过卡介苗者中,PPD皮肤试验阳性率为58.53%(127/217),ELISPOT阳性率为29.03%(63/217),斑点形成细胞数为32.44±26.52；在未接种卡介苗者中,PPD皮肤试验阳性率为24.83%(37/149),ELISPOT阳性率为35.57%(53/149),斑点形成细胞数为41.81±30.48.110例PPD和ELISPOT均为阴性的入伍新兵接种卡介苗10个月后,PPD皮肤试验阳转率为78.18%,而ELISPOT检测均为阴性.结论 ELISPOT具有较高的特异性和敏感性,能真实反映入伍新兵的结核潜伏感染情况,可推广应用.

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