摘要
目的探讨结核感染T细胞斑点试验(T-SPOT.TB)在临床中诊断结核的应用价值。方法回顾性研究2014年1月至2014年7月入住我院呼吸科患者122例,其中确诊肺结核64例,对照组58例,分别进行T-SPOT.TB检测、结核菌素试验(PPD试验)、结核抗体(TB-Ab)、血沉(ESR)。分析和比较T-SPOT.TB与传统诊断结核方法的灵敏度、特异度并对其检测结果进行相关分析。另对确诊肺结核的64例患者,分为涂阳、涂阴两组,均对T-SPOT.TB检测进行分析比较。结果 64例确诊肺结核中,58例T-SPOT.TB检测阳性,58例非结核中,7例T-SPOT.TB检测阳性,T-SPOT.TB检测灵敏度为90.63%,特异度为87.93%。T-SPOT.TB诊断结核的灵敏度显著高于TB-Ab 50.00%(P<0.001)和ESR 75.00%(P=0.019),但与PPD 87.50%差异不显著(P=0.571);特异度显著高于PPD 46.55%(P<0.001)、TBAb 70.69%(P=0.022)和ESR 48.28%(P<0.001);阳性预测值89.23%显著高于PPD、TB-Ab和ESR(P<0.01);诊断符合率89.34%显著高于PPD、TB-Ab和ESR(P<0.001)。在结核患者中,涂阳与涂阴两组T-SPOT.TB方法结核阳性检出率分别为92.86%和88.89%,无显著差异(P>0.05)。结论 TSPOT.TB检测与结核患者是否排菌无关,漏诊率明显降低。T-SPOT.TB检测的灵敏度优于TB-Ab和ESR,特异度优于PPD、TB-Ab和ESR,准确度符合率优于于传统结核诊断方法 PPD、ESR、TB-Ab,具有重要的临床诊断价值。
Objective To explore the diagnostic value of Tuberculous infection of T cells spot test（T-SPOT.TB） assay in pulmonary tuberculosis.Methods A restrospective study of 122 patients including 64 confirmed pulmonary tuberculosis and 58 controls from January to July,2014,in Guizhou Aerospace hospital.The T-SPOT.TB assay,tuberculin skin test （PPD）,tuberculosis antibody（TB-Ab）,erythrocyte sedimentation rate （ESR） were checked in both groups.The sensitivity and specificity of T-SPOT.TB assay in pulmonary tuberculosis （PTB） were evaluated and compared with traditional PTB diagnostic methods.Besides,the confirmed PTB was divided into smear-positive and smear-negative groups.T-SPOT.TB assay was checked in both groups and was evaluated between groups.Results A total of 58 out of 64 cases were T-SPOT.TB assay positive in the confirmed PTB group,whereas 7 out of 58 cases were T-SPOT.TB assay positive in the nontuberculosis group.The sensitivity and spicificity of T-SPOT.TB assay were 90.63％ and 87.93％,respectively.The sensitivity of T-SPOT.TB assay was higher than TB-Ab （50.00％,P =0.001） and ESR （75％,P＞O.001）,but there was no significant difference in the sensitivity between T-SPOT.TB assay and PPD（87.50％,P =0.571） ; The specificity of T-SPOT.TB assay （87.93％） was higher than PPD（46.55％,P ＜ 0.001）,ESR（48.28％,P ＜ 0.001） and TB-Ab （70.69％,P =0.022） ; Positive predictive value of T-SPOT.TB assay （89.23％） was significantly higher than PPD,TB-Ab and ESR （P 〈 0.01） ; Diagnosis coincidence rate of T-SPOT.TB assay （89.34％） was significantly higher than PPD,TB-Ab and ESR （P ＜ 0.001）.The positive rate of T-SPOT.TB assay in sputum smear-positive and sputum smear-negative groups were 92.86％ and 88.89％,respectively,there was no significant difference （P ＞ 0.05）.Conclusions T-SPOT.TB assay can be use as a diagnostic method without concerning whether tubercle bacillus were discharged by patients or not,thus can prevent a large number of m
出处
《中华肺部疾病杂志（电子版）》
CAS
2014年第6期32-36,共5页
Chinese Journal of Lung Diseases(Electronic Edition)
关键词
结核
肺
结核感染T细胞斑点试验
诊断
结核菌素试验
Pulmonary tuberculosis
Tuberculous infection of T cells spot test
Diagnosis
Tuberculin test
