非结核分枝杆菌病患者中结核感染 T 细胞检测试剂盒（酶联免疫斑点法）的临床评价。

Clinical evaluation of the QuantiFERON-TB Gold test in patients with non-tuberculous mycobacterial disease.

机构信息

Division of Respiratory Diseases, Department of Medicine, Kawasaki Medical School, Matsushima, Kurashiki, Japan.

出版信息

Int J Tuberc Lung Dis. 2009 Nov;13(11):1422-6.

PMID:19861017

Abstract

OBJECTIVE

To evaluate the clinical usefulness of the QuantiFERON TB-2G (QFT-2G) test in patients with non-tuberculous mycobacterial (NTM) disease without a previous history of tuberculosis (TB).

METHODS

The study consisted of 214 patients with NTM disease who satisfied the diagnostic guidelines of the American Thoracic Society.

RESULTS

The causative microorganism was Mycobacterium avium in 83 patients, M. intracellulare in 80, M. kansasii in 33, M. marinum in 12, M. szulgai in 3, M. abscessus in 2 and M. chelonei in 1. The positive response rate of QFT-2G test result was 2% in 163 patients with M. avium-intracellulare complex (MAIC) disease, 52% in 33 with M. kansasii disease, 58% in 12 with M. marinum disease, 33% in 3 with M. szulgai disease, 0% in two with M. abscessus disease and 0% in one with M. chelonei disease. The positivity of the QFT-2G test was 52% in patients with NTM disease, thought to be because NTM possesses common M. tuberculosis-specific antigens.

CONCLUSIONS

Although QFT-2G may be a useful diagnostic method to differentiate TB from MAIC disease, there are several problems to be resolved before it can be used as a diagnostic method for NTM disease (M. kansasii disease), including the determination of the positive cut-off level for QFT-2G test.

摘要

目的

评估结核分枝杆菌干扰素释放试验（QuantiFERON TB-2G，QFT-2G）在无结核病史的非结核分枝杆菌（NTM）病患者中的临床应用价值。

方法

本研究纳入了符合美国胸科学会诊断标准的 214 例 NTM 病患者。

结果

病原体为鸟分枝杆菌复合体（Mycobacterium avium-intracellulare complex，MAIC）的患者 83 例，胞内分枝杆菌 80 例，堪萨斯分枝杆菌 33 例，海分枝杆菌 12 例，脓肿分枝杆菌 2 例，溃疡分枝杆菌 1 例。在 MAIC 病患者中，QFT-2G 试验结果阳性率为 2%（163/830），堪萨斯分枝杆菌病患者中为 52%（33/63），海分枝杆菌病患者中为 58%（12/21），脓肿分枝杆菌病患者中为 33%（2/6），溃疡分枝杆菌病患者中为 0%（0/3），溃疡分枝杆菌病患者中为 0%（0/1）。NTM 病患者 QFT-2G 试验阳性率为 52%，这可能是由于 NTM 具有与结核分枝杆菌共同的特异性抗原。