目的 探讨结核菌特异性γ-干扰素(interferon-gamma,IFN-γ)酶联免疫斑点(enzyme-linked immunosorbent spot,ELISPOT)检测对结核性心包积液的诊断价值.方法 采用结核菌特异性IFN-γ ELISPOT技术同时检测20例结核性心包积液患者(TP组)和14例非结核性心包积液患者(Non-TP组)外周血单核细胞(peripheral blood mononuclear cells,PBMC)及心包积液单核细胞(pleural effusion mononuclear cells,PEMC)中结核菌特异性IFN-γ水平.结果 TP组PBMC和PEMC结核菌特异性IFN-γ水平均显著高于Non-TP组,差异有统计学意义(P<0.01,P<0.01).TP组心包积液中结核菌特异性IFN-y水平显著高于外周血IFN-γ水平,差异有统计学意义(P<0.01,P<0.01).PBMC ELISPOT检测结核性心包积液的敏感性和特异性分别为80.0%和85.7%;而PEMC ELISPOT敏感性和特异性为90.0%和85.7%.结论 结核菌特异性IFN-γELISPOT技术对结核性心包积液诊断和鉴别诊断具有很好的辅助价值.
Objectives To observe the clinical utility of the mycobacterium tuberculosis antigen-specific interferon-gamma (IFN-γ) enzyme-linked immunosorbent spot (ELISPOT) assay in the diagnosis of tuberculous pericardial effusion.Methods IFN-γELISPOT assay was used to determine the mycobacterium tuberculosis antigen-specific IFN-γ productions of peripheral blood mononuclear cells (PBMCs) and pleural effusion mononuclear cells (PEMCs) in 20 patients with tuberculous pericardial effusion (TP group) and 14 patients with non-tuberculous pericardial effusion (Non-TP group).Results The productions of antigen-specific IFN-γin PBMCs and in PEMCs of tuberculous pericardial effusion patients were significantly higher than those of non-tuberculous pericardial effusion patients (P〈0.01,P〈0.01).The production of antigen-specific IFN-γin PEMCs was much more higher than that in PBMCs of tuberculous pericardial effusion patients (P〈0.01,P〈0.01).The sensitivity and specificity of ELISPOT assay in PBMCs and PEMCs were 80.0%,85.7% and 90.0%,85.7% respectively.Conclusions Mycobacterium tuberculosis antigen-specific IFN-γ ELISPOT assay is useful in improving the diagnosis of tuberculous pericardial effusion.