Efficacy of T-SPOT.TB in Treatment of Active Tuberculosis
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摘要:
目的 探讨结核感染T细胞斑点试验（T-SPOT.TB）对肺结核治疗效果的监测意义。 方法 采用T-SPOT.TB试剂盒，检测其抗原ESAT-6和CFP-10的应答，对比79例活动性肺结核患者治疗前与治疗2月末及治疗结束时ESAT-6和CFP-10应答结果的变化。 结果 79例活动性肺结核患者，ESAT-6和CFP-10应答的斑点数在治疗2月末和治疗结束时较治疗初均有明显下降，与治疗初比较，差异均有统计学意义（P < 0.05）。ESAT-6和CFP-10在治疗2月末和治疗结束时阴性率较治疗初有上升，与治疗初的阴性率比较，差异无统计学意义（ P > 0.05）；全部患者T-SPOT.TB转阴率为3.8%。治疗2月末与治疗结束时ESAT-6应答变化，差异有统计学意义（ χ2 = 4.635，P = 0.031 < 0.05）；治疗2月末与治疗结束时CFP-10应答变化，差异无统计学意义（ χ2 = 1.272，P = 0.259 > 0.05）。 结论 T-SPOT.TB治疗前后ESAT-6、CFP-10应答变化有明显差异，对肺结核治疗效果评价有一定作用，但不能利用其转阴率作为肺结核治疗停药指标。 -
关键词:
- 结核感染T细胞斑点试验 /
- ESAT-6 /
- CFP-10 /
- 肺结核 /
- 治疗效果
Abstract:Objective To explore the significance of T-SPOT.TB test for monitoring the therapeutic effect of tuberculosis. Methods Using T-SPOT.TB kit, changes in response to ESAT-6 and CFP-10 were compared in 79 patients with active pulmonary tuberculosis before and after 2 months of treatment. Results In 79 patients with active pulmonary tuberculosis, The spot number of ESAT-6 and CFP-10 responses decreased significantly at the end of 2 months and at the end of treatment compared with the beginning of treatment, and the difference was statistically significant（P < 0.05）. The negative rates of ESAT-6 and CFP-10 at the end of 2 months and at the end of treatment were higher than those at the beginning of treatment, but there was no significant difference between them（ P > 0.05）. The T-SPOT.TB negative conversion rate of all patients was 3.8%.There was a statistical difference in ESAT-6 response between the end of 2 months and the end of treatment（ χ2 = 4.635, P = 0.031 < 0.05）.There was no significant difference in CFP-10 response at the end of treatment 2 and at the end of treatment（ χ2 = 1.272, P = 0.259 > 0.05）. Conclusion There were significant differences in ESAT-6 and CFP-10 of T-SPOT.TB responses before and after treatment. T-SPOT has a certain significance in evaluating of the therapeutic effect of tuberculosis, but its negative conversion ration can not be used as the indicator of ending the TB treatment. -
Key words:
- T-SPOT.TB /
- ESAT - 6 /
- CFP - 10 /
- Tuberculosis /
- Treatment effect
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表 1 治疗前后斑点数变化[M（P25，P75）]
Table 1. Changes of spot number before and after treatment[M（P25，P75）]
组别 例数（n） 免疫斑点数 HA PA HB PB ESAT-6（A） CFP-10（B） 治疗初 79 81（40，153） 87（16，183） 15.886 0.000 6.602 0.037 2月末 79 47（20，92）* 47（14，124）* 停药时 79 37（18，80） 37（10，116） 与治疗初比较，*P < 0.05。 
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表 2 治疗前后ESAT-6和CFP-10转阴率比较[n（%）]
Table 2. Comparison of the negative rate of ESAT-6 and CFP-10 before and after treatment[n（%）]
组别 例数（n） 免疫斑点阴阳比较 χA2 PA χB2 PB ESAT-6（A） CFP-10（B） 治疗初 79 2（2.5） 6（7.6） 2月末 79 3（3.8） 13（16.5） 0.207 0.649 2.931 0.087 停药时 79 6（7.6） 11（16.2） 2.107 0.147 1.648 0.199 注：2月末与治疗初统计比较用χA，PA，停药时与治疗初统计比较用χB，PB。
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表 3 治疗前后ESAT-6和CFP-10应答变化比较[n（%）]
Table 3. Comparison of ESAT-6 and CFP-10 responses before and after treatment[n（%）]
ESAT-6 CFP-10（2月末） 总数 CFP-10（停药时） 总数 上升 下降 上升 下降 上升 12 10 22（27.8） 7 4 11（13.9） 下降 2 55 57（72.2） 2 66 68（86.1） 总数 14（17.7） 65（82.3） 79 9（11.4） 70（88.6） 79
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