T淋巴细胞酶联免疫斑点法在肺外结核诊断中的应用

被引：10

作者：

陆迪雅

陈澍

机构：

[1] 复旦大学附属华山医院感染科

来源：

中华传染病杂志 | 2013年 / 06期

关键词：

D O I：

暂无

中图分类号：

R52 [结核病];

学科分类号：

100201 [内科学];

摘要：

<正>据世界卫生组织(WHO)报道,全球近1/3人群感染结核分枝杆菌,其中肺外结核占所有结核病的15%～20%。相对于肺结核,目前肺外结核诊断存在很多困难,主要原因是肺外结核感染途径和感染部位多样,临床表现复杂,缺乏特异性。现有的实验室检查包括涂片抗酸染色、结核分枝杆菌培养等,阳性率较低。结核菌素(PPD)试验是临床常用的筛查结核的免疫学方法,但有较高的假阳性率和假阴性率。因此,寻找一种对肺外结核诊断特异性高、敏感性好的手段十分重要。T淋巴细胞酶联免疫斑点法(T-SPOT.TB)2001年由Lalvani等发明,是利用酶联免疫斑点法(enzyme-linkedimmunospot assay,ELISPOT法)检测分泌IFN-γ的结核特异性T淋巴细胞水平的实验方法。该方法源于Mahairas等于1996年在结核分枝杆菌中发现的一段高度保守的差异区1(RD1)的基因序列,该基因序列仅存在于致病性结核分枝杆菌中,而不存在于卡介苗菌株和大部分环境中的分枝杆菌中。因此,RD1编码产生的早期分泌抗原靶6(ESAT-6)和培养滤液蛋白10(CFP-10)可作为特异性抗原刺激机体T淋巴细胞产生特异性的细胞因子IFNγ,以此反映机体对结核的免疫状况,从而对结核感染进行辅助诊断。据国外文献报道,T-SPOT.TB诊断结核

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