标题：结核感染T细胞斑点试验对结核病治疗效果的监测价值

      作者：何紫琪，李从荣
    （武汉大学人民医院检验科，湖北 武汉 430060）

      卷次： 2016年27卷12期

      【摘要】 目的 探讨结核感染T细胞斑点试验对结核病治疗疗效的监测意义。方法 本研究采用T-SPOT.TB
试剂盒，检测T细胞中γ-干扰素对结核分支杆菌特异性多肽类早期分泌性抗原靶标6-kD(ESAT-6)和培养滤液蛋白
(CFP-10)的应答，对比113例结核感染者治疗前与治疗后T-SPOT.TB结果的变化，其结果根据对该试验中两种抗原
的联合与各自应答来分析。结果 113例感染者在治疗后T-SPOT.TB结果转阴者有42例 (37.2%)。其中，CFP-10
转阴率占48.9% (P<0.001)，ESAT-6转阴率占20.0% (P=0.238)。ESAT-6的斑点形成细胞(SFCs)/2.5×105外周血单核
细胞(PBMCs)的平均数在治疗前和治疗后分别为18.47和16.29 (P=0.16)，而CFP-10的SFCs/PBMCs的平均数在治
疗前和治疗后分别为22.83和15.31 (P<0.01)。结论 结核病治疗对于T细胞中γ-干扰素引起的ESAT-6和CFP-10
抗原应答影响不同，CFP-10的定量应答才是结核病治疗的更有效监测手段。

      【关键词】 结核感染T细胞斑点试验；早期分泌性抗原靶标6-kD蛋白；培养滤液蛋白CFP-10；结核病治疗

      【中图分类号】 R52 【文献标识码】 A 【文章编号】 1003—6350（2016）12—1923—03


Value of T-SPOT.TB assay on monitoring the tuberculosis treatment efficacy.
HE Zi-qi, LI Cong-rong. Department
of Clinical Laboratory, Renmin Hospital of Wuhan University, Wuhan 430060, Hubei, CHINA

【Abstract】 Objective To explore the value of T-SPOT.TB assay on monitoring the tuberculosis treatment
efficacy. Methods We used the T-SPOT.TB assay to measure T-cell interferon-γ responses to Mycobacterium tuber-
culosis-specific peptides early secretory antigenic target 6-kD protein (ESAT-6) and culture filtrate protein 10
(CFP-10) in 113 patients with tuberculosis before and after the treatment. The results of changes in T-SPOT.TB be-
fore and after the treatment were analyzed according to the combined and separate responses to ESAT-6 and
CFP-10 antigens. Results When the treatment was completed, 42 (37.2%) of 113 patients with tuberculosis reverted
to negative according to the T-SPOT.TB results, of which CFP-10 reversion rate was 48.9% (P<0.001), and the ESAT-6
reversion rate was 20.0% (P=0.238). The mean number of spot-forming cells (SFCs)/2.5×105 peripheral blood mononucle-
ar cells (PBMCs) pre-and post-treatment were respectively 18.47 versus 16.29 for ESAT-6 (P=0.16) and 22.83 versus
15.31 for CFP-10 (P<0.01). Conclusion Tuberculosis treatment has a differential effect on T-cell responses to ESAT-6
and CFP-10 as measured by T-SPOT.TB. The quantitative response to CFP-10 may be a more useful monitoring tool for
treatment efficacy.

      【Key words】 T-SPOT.TB assay; Early secretory antigenic target 6-kD protein (ESAT-6); Culture filtrate protein
10 (CFP-10); Tuberculosis treatment
·论 著·
6350.2016.12.008