摘要
目的探讨结核感染T细胞检测(tuberculosis T cell spot detection, T-SPOT.TB)、利福平耐药实时荧光定量核酸扩增技术(Gene Xpert MTB/RIF)在艾滋病(acquired immune deficiency syndrome,AIDS)合并继发性肺结核(tuberculosis,TB)人群中的诊断价值。方法选取2019年1月—2020年9月在我院进行就诊的疑似肺结核患者323例资料进行分析,所有纳入病例均进行T-SPOT.TB、Gene Xpert MTB/RIF、痰涂片找抗酸杆菌、痰结核菌培养、抗HIV、CD4+淋巴细胞检查。以临床诊断结果为参考标准,比较T-SPOT.TB、Gene Xpert MTB/RIF、痰涂片、痰培养在艾滋病合并继发性肺结核人群中诊断的敏感性、特异性。结果综合临床症状、实验室检查及影像学检查结果,将符合条件的患者分两组:艾滋病合并继发性性肺结核(AIDS/TB)组77例,继发性肺结核(TB)组132例,比较2组患者T-SPOT.TB、Gene Xpert MTB/RIF、痰涂片、痰培养的敏感性、特异性。AIDS/TB组与TB组在T-SPOT.TB、Gene Xpert MTB/RIF、痰涂片检测阳性率方面差异无统计学意义,两组患者痰培养阳性率差异有统计学意义(P <0.05)。T-SPOT.TB诊断艾滋病合并继发性肺结核中检测的敏感性和特异性分别为79.22%、89.29%,Gene Xpert MTB/RIF诊断艾滋病合并继发性肺结核中检测的敏感性和特异性分别为54.55%、100%。不同CD4^(+)T淋巴细胞计数患者T-SPOT.TB、Gene Xpert阳性率差异无统计学意义。结论 T-SPOT.TB、Gene Xpert MTB/RIF在艾滋病合并继发性肺结核的早期诊断中有一定的诊断价值。
Objective To evaluate the diagnostic value of Tuberculosis T cell spot detection(T-SPOT.TB)and Xpert Mtb/RIF detection technique in Acquired Immune Deficiency Syndrome(AIDS)/Tuberculosis(TB)coinfected patients.Methods A total of 323 suspected tuberculosis patients admitted to our hospital from January 2019 to September 2020 were selected for analysis.All the included patients were examined by T-SPOT.TB,Gene Xpert MTB/RIF,sputum smear for acid-fast bacilli,sputum tuberculosis culture,anti-HIV,and CD4+lymphocytes.The sensitivity and specificity of T-SPOT.TB,Gene Xpert MTB/RIF,sputum smear and sputum culture in the diagnosis of AIDS/TB was compared.Results According to clinical symptoms,laboratory examination and imaging examination results,the eligible patients were divided into two groups:AIDS/TB group(77 cases)and TB group(132 cases).The sensitivity and specificity of T-SPOT.TB,Gene Xpert MTB/RIF,sputum smear and sputum culture were compared between the two groups.There was no statistically significant difference between AIDS/TB group and TB group in the detection of positive rates by T-SPOT.TB,Gene Xpert MTB/RIF,sputum smear,the difference in the positive rate of sputum culture between the two groups was statistically significant(P<0.05).The sensitivity and specificity of T-SPOT.TB in the diagnosis of AIDS/TB were 79.22%and 89.29%,respectively,and those of Gene Xpert MTB/RIF in the diagnosis of AIDS/TB were 54.55%and 100%,respectively.There were no statistically significant differences in the positive rates of T-SPOT.TB and Gene Xpert among patients with different CD4^(+)T lymphocyte counts.Conclusion T-SPOT.TB and Gene Xpert MTB/RIF have certain diagnostic value in the early diagnosis of AIDS/TB.
作者
姚正钢
陈勇毅
蓝梦颖
YAO Zhenggang;CHEN Yongyi;LAN Mengying(Infectious Diseases Department,Yangjiang Public Health Hospital of Guangdong Province,Yangjiang Guangdong 529500,China)
出处
《中国卫生标准管理》
2021年第12期75-78,共4页
China Health Standard Management
基金
2019年度阳江市医疗卫生类科技计划项目(173)。
