摘要
目的 评估并比较Xpert MTB/RIF和T-SPOT.TB对涂阴肺结核的诊断价值。方法 收集2014年12月至2015年12月天津市海河医院门诊和住院的呼吸疾病患者208例,分为结核组125例和对照组83例,同时对其痰液样本行涂片镜检、液体快速培养和Xpert MTB/RIF检测,对其血液样本行T-SPOT.TB试验。结果 Xpert MTB/RIF诊断涂阴肺结核的敏感性、特异性、ROC曲线下面积（AUC）及优势比（odds ratio,OR）分别为56.5%（95%CI：45.8%~66.8%）、98.8%（95%CI：93.5%~100.0%）、0.777（95%CI：0.708~0.836）及106.60（χ^2=62.87,P〈0.01）;T-SPOT.TB诊断涂阴肺结核的敏感性、特异性、AUC及OR值分别为83.7%（95%CI：74.5%~90.5%）、62.7%（95%CI：51.3%~73.0%）、0.732（95%CI：0.660~0.796）及8.61（χ^2=39.44,P〈0.01）;两者敏感性（χ^2=18.58）和特异性（χ^2=28.03）的差异有统计学意义（P〈0.05）,AUC的差异无统计学意义（Z=1.235,P〉0.05）;Xpert MTB/RIF阴性的涂阴肺结核患者T-SPOT.TB阳性率为70.0%。结论 Xpert MTB/RIF和T-SPOT.TB均有助于早期、快速、准确地辅助诊断肺结核,T-SPOT.TB可以作为Xpert MTB/RIF的后续试验辅助诊断Xpert MTB/RIF阴性的涂阴肺结核。
Objective To evaluate and compare the values of Xpert MTB/RIF and T-SPOT. TB in the diagnosis of smear-negative pul- monary tuberculosis. Methods A total of 208 patients with respiratory diseases from Haihe Hospital of Tianjin City during December 2014 and December 2015 were enrolled, and divided into pulmonary tuberculosis group （ n = 125 ） and control group （ n = 83 ）. Their sputum samples were used for smear microscopy, fast culture and Xpert MTB/RIF analysis, respectively, and blood samples for the T- SPOT. TB test. Results The sensitivity, specificity, area under the receiver operating characteristic curve （AUC^ROC） and odds ratio of Xpert MTB/RIF and T-SPOT. TB in the diagnosis of smear-negative pulmonary tuberculosis were 56.5% （95% CI： 45.8%-66.8% ） and 83.7% （95% CI： 74.5%-90.5% ）, 98.8% （95% CI： 93.5%-100.0% ） and 62.7% （95% CI： 51.3%-73.0% ）, 0. 777 （95% CI： 0.708-0.836） and0.732（95% CI： 0.660-0.796）, and 106.60（X2 =62.87, P〈0.01） and 8.61（X^2 =39.44, P〈 O. 01 ） , respectively. There were significant differences in sensitivity and specificity （X^2 = 18.58 and 28.03, P 〈 0.05 ） but not AUC^ROC （Z = 1. 235, P 〉 0.05 ） between Xpert MTB/RIF and T-SPOT. TB. The positive rate of T-SPOT. TB in the pulmonary tubercu- losis patients with negative smear and negative Xpert MTB/RIF was 70.0%. Conclusion Both of Xpert MTB/RIF and T-SPOT. TB were helpful for the early, rapid and accurate diagnosis of pulmonary tuberculosis, and T-SPOT. TB may be used as a follow-up test for the pulmonary tuberculosis patients with negative smear and negative Xpert MTB/RIF.
出处
《临床检验杂志》
CAS
CSCD
2016年第10期755-757,共3页
Chinese Journal of Clinical Laboratory Science
