摘要
目的评价结核分枝杆菌脱氧核糖核酸(TB-DNA)检测、结核感染T细胞酶联免疫斑点试验(T-SPOT.TB)和结核抗体(TB-Ab)检测3种方法在肺结核诊断中的应用价值。方法收集2019年1-12月商洛某三甲医院收治的245例疑似肺结核患者的一般资料,根据最终诊断结果分为肺结核患者组(试验组)和非结核病患者组(对照组)。比较TB-DNA、TB-Ab和T-SPOT.TB 3种方法平行检测结果在两组中的差异,并分析TB-DNA、TB-Ab和T-SPOT.TB在肺结核诊断中的应用价值。结果试验组的TB-DNA、T-SPOT.TB和TB-Ab的阳性率均高于对照组,差异均有统计学意义(P<0.05)。运用受试者工作特征曲线(ROC曲线)分析,T-SPOT.TB抗原A、T-SPOT.TB抗原B、TB-DNA、TB-Ab的ROC曲线下面积分别是0.908、0.881、0.677、0.649。这3种方法在肺结核诊断中以TB-DNA的特异度(97.14%)最高,T-SPOT.TB的灵敏度(89.14%)最高。T-SPOT.TB的诊断符合率高于TB-DNA和TB-Ab,差异均有统计学意义(P<0.05),TB-DNA和TB-Ab的诊断符合率差异无统计学意义(P>0.05)。联合检测可以提高灵敏度,T-SPOT.TB联合TB-DNA具有最高的诊断符合率。结论T-SPOT.TB具有较高的灵敏度、特异度和诊断符合率,在肺结核诊断中具有较高价值,科学地选择组合项目检测可以提高诊断符合率。
Objective To evaluate the application value of TB-DNA,T-SPOT.TB and TB-Ab methods in pulmonary tuberculosis diagnosis.Methods The general data in 245 cases of suspected pulmonary tuberculosis treated in a class 3A hospital of Shangluo from January to December 2019 were collected.According to the final diagnosis results,the patients were divided into the pulmonary tuberculosis patients group(experimental group)and non-pulmonary tuberculosis patients group(control group).The differences in the parallel detection results of TB-DNA,TB-Ab and T-SPOT.TB were compared between the two groups,and the application values of TB-DNA,TB-Ab and T-SPOT.TB in pulmonary tuberculosis diagnosis were analyzed.Results The positive rates of TB-DNA,T-SPOT.TB and TB-Ab in the experimental group were higher than those in the control group,and the differences were statistically significant(P<0.05).In the analysis of the receiver operating characteristic(ROC)curve,the area under the ROC curve of T-SPOT.TB antigen A,T-SPOT.TB antigen B,TB-DNA and TB-AB were 0.908,0.881,0.677 and 0.649 respectively.The specificity of TB-DNA for diagnosing pulmonary tuberculosis among 3 methods was the highest(97.14%)and the sensitivity of T-SPOT.TB was the highest(89.14%).The diagnostic coincidence rate of T-SPOT.TB was higher than that of TB-DNA and TB-AB,the differences were statistically significant(P<0.05),and the diagnostic coincidence rate of TB-DNA and TB-AB was not statistically significant(P>0.05).The combined detection could increase the sensitivity,and T-SPOT.TB combined with TB-DNA had the highest diagnostic coincidence rate.Conclusion T-SPOT.TB has the high sensitivity,specificity and diagnostic coincidence rate,and has the higher value in pulmonary tuberculosis diagnosis.Scientific selection of combination items test can increase the diagnostic coincidence rate.
作者
何家花
余成强
李步荣
刘晓良
HE Jiahua;YU Chengqiang;LI Burong;LIU Xiaoliang(Department of Medical Laboratory,Shangluo Central Hospital,Shangluo,Shaanxi 726000,China;Department of Medical Laboratory,Second Affiliated Hospital of Xi′an Jiaotong University,Xi′an,Shaanxi 710004,China)
出处
《检验医学与临床》
CAS
2021年第1期67-69,72,共4页
Laboratory Medicine and Clinic
关键词
肺结核
斑点试验
结核抗体
诊断效能
pulmonary tuberculosis
spot test
anti-tuberculosis antibody
diagnostic efficiency
