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目的 探讨T细胞酶联免疫斑点法(T SPOT)在我国用于诊断艾滋病合并结核病的应用价值.方法 应用T SPOT对35例明确诊断的艾滋病合并结核病患者的血液样本进行结核分枝杆菌特异性T细胞的检测,同时对所有患者做PPD试验进行比较.结果 在艾滋病合并结核病的所有患者、CD4<200/μl、CD4>200/μl、抗结核疗程<2个月及抗结核疗程>2个月的各组患者中,T SPOT检测的阳性检出率分别为65.71%、66.67%、60.00%、83.33%和25.00%,而PPD试验的阳性检出率仅为24.24%、25.00%、33.33%、9.09%和25.00%,其中在患者总体、CD4<200/μl组、抗结核疗程<2个月组中,T SPOT检测的阳性检出率远高于PPD试验,差异有统计学意义(P<0.05).结论 TSPOT检测的敏感性高于目前常用的PPD试验,适用于我国艾滋病合并结核病的快速诊断.

Objective To evaluate the application of enzyme-linked immunospot assay (T SPOT) in diagnosis of Mycobacterium tuberculosis (MTB) infection for AIDS patients. Methods The rapid T SPOT assay was employed to detect ESAT-6 and CFP-10 specific T cells in blood samples from 35 AIDS patients with active tuberculosis. The results were compared with those of PPD skin test. Results The positive-MTB rate with T SPOT assay in all patients (n = 35 ) was 65.71%, that in patients with CD4 < 200/μ (n = 21) was 66.67%, in patients with CD4 > 200/μl (n = 10) was 60.0% , in patients with anti-tuberculosis treatment < 2 months ( n = 15 ) was 83.33% and in patients with treatment > 2 months ( n = 6 ) was 25.00%. The positive rates of PPD skin test were 24.24%, 25.00%, 33.33%, 9.09% and 25.00% in these groups, respectively. The positive rates of T SPOT assay were significantly higher than those of PPD skin test in all patients, in those with CD4 < 200/μl and with anti-tuberculosis treatment < 2 months ( P < 0.05 ). Conclusion T SPOT assay was more sensitive than conventional PPD skin test, and can be applied in the diagnosis of MTB infections for AIDS patients.