Arenas Miras Maria Del Mar, Hidalgo-Tenorio Carmen, Jimenez-Gamiz Pilar, Jiménez-Alonso Juan
Department of Internal Medicine, University Hospital Virgen de las Nieves, Avenida de las Fuerzas Armadas No. 2, 18004 Granada, Spain.
Department of Infectious Diseases, University Hospital Virgen de las Nieves, Avenida de las Fuerzas Armadas No. 2, 18004 Granada, Spain.
Biomed Res Int. 2014;2014:291031. doi: 10.1155/2014/291031. Epub 2014 May 28.
Early studies in patients with systemic lupus erythematosus (SLE) reported increased incidence of tuberculosis. The tuberculin skin test (TST) is the technique of choice to detect latent tuberculosis infection (LTBI) but has several limitations.
We compared TST and the newer T.SPOT.TB test to diagnose LTBI in SLE patients.
In this observational cohort study conducted between August 2009 and February 2012, we recruited 92 patients from those attending the SLE clinic of our university hospital. Data recorded were epidemiological and sociodemographic characteristics. Laboratory analyses included TST and T.SPOT.TB tests.
Of the patients studied, 92% were women with an average age of 42.7 years. Overall, the degree of correlation between the two tests was low (Kappa index = 0.324) but was better in patients not receiving corticosteroids (CTC)/immunosuppressive (IS) therapy (Kappa = 0.436) and in those receiving hydroxychloroquine (Kappa = 0.473). While TST results were adversely affected by those receiving CTC and/or IS drugs (P = 0.021), the T.SPOT.TB results were not.
Although the TST test remains a useful tool for diagnosing LTBI in SLE patients, the T.SPOT.TB test is perhaps better employed when the patient is receiving CTC and/or IS drugs.
早期对系统性红斑狼疮（SLE）患者的研究报告称结核病发病率增加。结核菌素皮肤试验（TST）是检测潜伏性结核感染（LTBI）的首选技术，但有几个局限性。
我们比较了TST和更新的T.SPOT.TB试验在诊断SLE患者LTBI中的作用。
在2009年8月至2012年2月进行的这项观察性队列研究中，我们从我校医院SLE门诊就诊的患者中招募了92名患者。记录的数据包括流行病学和社会人口学特征。实验室分析包括TST和T.SPOT.TB试验。
在研究的患者中，92%为女性，平均年龄42.7岁。总体而言，两种试验之间的相关性程度较低（卡帕指数 = 0.324），但在未接受皮质类固醇（CTC）/免疫抑制（IS）治疗的患者中相关性较好（卡帕 = 0.436），在接受羟氯喹的患者中也是如此（卡帕 = 0.473）。虽然接受CTC和/或IS药物的患者TST结果受到不利影响（P = 0.021），但T.SPOT.TB结果不受影响。
虽然TST试验仍然是诊断SLE患者LTBI的有用工具，但当患者接受CTC和/或IS药物治疗时，T.SPOT.TB试验可能更适用。
