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T-SPOT.TB联合cIFN-γ可提高TBM诊断有效性

2016-03-03  来源:艾兰博曼医学网  作者:咿呀呀  编辑:faliuxue
导读
据上海华山医院研究人员近期发表在Lab Med 杂志上的一则研究结果显示,T-SPOT TB联合cIFN-γ可提高结核性脑膜炎(TBM)的诊断有效性。在监控结核性脑膜炎的过程中动态观察

  据上海华山医院研究人员近期发表在Lab Med 杂志上的一则研究结果显示,T-SPOT.TB联合cIFN-γ可提高结核性脑膜炎(TBM)的诊断有效性。在监控结核性脑膜炎的过程中动态观察cIFN-γ的水平非常有用,因为在经过治疗后该标志物水平是显著下降的。

  为评价外周血T-SPOT.TB联合脑脊液干扰素γ(cIFN-γ)对结核性脑膜炎的诊断有效性,研究人员纳入了69例受试对象进行临床研究,其中结核性脑膜炎患者30例,对照组39例。

  采用酶联免疫斑点(ELISPOT)对IFN-γ分泌T细胞进行检测。研究人员分别在第0周和第4周从结核性脑膜炎患者中搜集10例患者的外周血进行观察监测变化。

  研究结果显示,外周血T-SPOT.TB检测结核性脑膜炎的敏感性和特异性分别为70%和87%。cIFN-γ对结核性脑膜炎的ROC曲线下面积为0.819,校正后的敏感性和特异性分别为83%和85%。另外该研究发现,当T-SPOT.TB和cIFN-γ检测均为阳性时,他们对结核性脑膜炎诊断的阳性预测值的特异性可以达到100%。

  最后该研究认为,T-SPOT.TB和cIFN-γ的联合应用可提高结核性脑膜炎(TBM)的诊断有效性。同时在结核性脑膜炎的监控过程中对cIFN-γ水平的动态监测是非常有用的,因为在经过治疗后该标志物的水平出现显著下降。


英文原文


Diagnosis of Tuberculous Meningitis Using a Combination of Peripheral Blood T-SPOT.TB and Cerebrospinal Fluid Interferon-γ Detection Methods.

Abstract

OBJECTIVE:

To evaluate the effectiveness of combined peripheral blood T-SPOT.TB and cerebrospinal fluid interferon-γ (cIFN-γ) detection methods in the diagnosis of tuberculous meningitis (TBM).

METHODS:

A total of 30 individuals with TBM and 39 control individuals without TBM participated in this study. IFN-γ-secreting T cells were detected by enzyme-linked immunospot (ELISPOT), and cIFN-γ was detected by enzyme-linked immunosorbent assay (ELISA). We collected cerebrospinal fluid from 10 patients in the TBM group on initial visit and at 4 weeks, to observe changes.

RESULTS:

The sensitivity and specificity of peripheral-blood T-SPOT.TB testing in the diagnosis of TBM were 70% and 87%, respectively. The area under the ROC curve of cIFN-γ for TBM diagnosis was 0.819, and the corresponding sensitivity and specificity were 83% and 85%, respectively. When T-SPOT.TB and cIFN-γ results were positive, the specificity and positive predictive value of TBM diagnosis reached 100%.

CONCLUSIONS:

Combined use of T-SPOT.TB and cIFN-γ could improve the diagnosis efficiency of TBM. Dynamic observation of cIFN-γ is also important in monitoring TBM because the level of this analyte significantly decreases after treatment.


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