JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES) ›› 2016, Vol. 54 ›› Issue (6): 82-86.doi: 10.6040/j.issn.1671-7554.0.2015.713

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Screening results and influencing factors of T-SPOT.TB assay in patients with autoimmune rheumatic diseases

GAI Linlin1*, GUAN Lixue2*, LI Haibo2, CHU Jinjin2, ZHU Yun3, LI Ming3   

  1. 1. Department of Clinical Laboratory Diagnostics, Weifang Medical University, Weifang 261053, Shandong, China;
    2. Central Laboratory, Weifang Peoples Hospital, Weifang 261041, Shandong, China;
    3. Department of Rheumatology, Weifang Peoples Hospital, Weifang 261041, Shandong, China
  • Received:2015-07-29 Online:2016-06-20 Published:2016-06-20

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Abstract: Objective To investigate the status of latent tuberculosis infection(LTBI)in patients with autoimmune rheumatic diseases and the factors associated with a T-cell enzyme-linked immunospot assay(T-SPOT.TB). Methods During June 2013 and June 2014, a total of 223 patients with various autoimmune rheumatic diseases(patient group)and 53 healthy subjects(control group)were enrolled and screened for LTBI by T-SPOT.TB tests. Data on tuberculosis exposure, use of glucosteroid and disease-modifying anti-rheumatic drugs(DMARDs), BCG vaccination history and abnormal CT scans were collected. Miettinen test was used to estimate odds ratios(OR)and 95% confidence intervals(CI). Results T-SPOT.TB-positive rate was 20.18% in the patient group and 5.66% in the control group, and the patient group had higher risk of LTBI(OR=4.21, 95%CI: 1.21-14.70, P<0.05). There were significant 山 东 大 学 学 报 (医 学 版)54卷6期 -盖林林,等.免疫性疾病患者T-SPOT.TB筛查结果及影响因素 \=-differences in T-SPOT.TB-positive rate and OR among various autoimmune rheumatic diseases. The T-SPOT.TB positive rate was 44.0% in patients with erythema nodosumts(OR=13.11, 95%CI: 3.44-49.98, P<0.01), and 21.16% in patients with rheumatoid arthritis(RA)(OR=4.47, 95%CI: 1.06-18.82, P<0.05), obviously higher than that of controls. The T-SPOT.TB positive rate in patients with other rheumatic autoimmune diseases was 10.0%-33.34%(OR=1.85-8.3, P>0.05). There were no significant differences between the proportions of patients treated with glucocorticoid and DMARDs in T-SPOT.TB-positive and T-SPOT.TB-negative groups(P>0.05). Previous active TB and an abnormal CT examination were significantly associated with T-SPOT.TB-positive rate(P<0.01). Conclusion Patients with autoimmune rheumatic diseases are at increased risk of LTBI(OR=4.21). The glucocorticoid and DMARDs treatment have little effect on T-SPOT.TB results. It is an effective method to screen LTBI with T-SPOT.TB in patients with autoimmune rheumatic diseases.

Key words: Influencing factors, Relative risk of tuberculosis infection, Latent tuberculosis infection, Screening, Autoimmune rheumatic diseases

CLC Number: 

  • R735.2
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