摘要
目的探讨结核感染T细胞试验(T-SPOT.TB)中两种抗原6 kD早期分泌靶向抗原(ESAT-6)及10 k D培养滤过蛋白(CFP-10)在感染性脊椎炎鉴别诊断中的价值。方法回顾性分析2014年7月到2017年7月就诊于我院,完成T-SPOT.TB及相关检查,最终均通过血培养、病理组织学和脓液培养等手段明确病原学诊断的患者共59例(结核性脊椎炎38例、布鲁氏菌性脊椎炎11例和化脓性脊椎炎10例)。绘制ROC曲线并分析ESAT-6、CFP-10在不同类型感染性脊椎炎中的作用;应用kappa一致性分析检验ESAT-6、CFP10在结核性脊椎炎患者中诊断的一致性。结果 ESAT-6敏感度为84.2%、特异度为90.5%;CFP-10敏感度为76.3%、特异度为100%。两种斑点计数结果具有较高的一致性(kappa=0.660,P <0.05),但ESAT-6与病原学诊断结果一致性更高。结论 ESAT-6具有较高的可信度可运用于感染性脊椎炎的鉴别诊断。
Objective To investigate the differential diagnosis value of two antigens(ESAT-6 and CFP-10)in T-SPOT.TB kit for vertebral osteomyelitis.Methods Retrospective analysis was conduced by investigating 59 cases(38 cases of TVO,11 cases of BVO and 10 cases of PVO)diagnosed in the First Affiliated Hospital of Kunming Medical University from July 2014 to July 2017 and underwent T-SPOT.TB and related laboratory exami-nations.All cases were diagnosed etiologically by blood culture,histopathology and pus culture.The differential val-ue of ESAT-6 and CFP-10 in varied vertebral osteomylitis was analyzed with ROC curve.The kappa analysis was applied to checkout the consistency of ESAT-6 and CFP-10.Results The sensitivity and specificity of ESAT-6 was 0.842 and 0.905,respectively.The sensitivity and specificity of CFP-10 was 0.763 and 1.000,respectively.The results of two antigenic spots showed a higher consistency(kappa=0.660,P<0.05).However,the result of ESAT-6 was more consistent with the final diagnoses.Conclusion ESAT-6 is reliable in differential diagnosis of vertebral osteomylitis.
作者
孙宇鹏
何少波
张春强
杜开利
郭培宇
赵润民
SUN Yupeng;HE Shaobo;ZHANG Chunqiang;DU Kaili;GUO Peiyu;ZHAO Runmin(First Affiliated Hospital,Kunming Medical University,Kunming 650032,China)
出处
《实用医学杂志》
CAS
北大核心
2018年第18期3051-3054,共4页
The Journal of Practical Medicine
基金
云南省科技厅-昆明医科大学联合项目(编号:2013FZ269
2014FB025)
云南省骨科研究所内设机构基金(编号:2016NS022
2017NS024
2017NS048
2018NS0104)
