贵州医科大学学报

2017, v.42;No.203(08) 924-927+932

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T-SPOT.TB技术对疑似结核病患者的诊断价值
Evaluation of T-SPOT.TB Assays in the Diagnosis of Tuberculosis Patients

罗振华;胡方芳;李伟;成荣;杨斌;金婷婷;李红凌;张华;
LUO Zhenhua;HU Fangfang;Li Wei;CHENG Rong;YANG Bin;JIN Tingting;LI Hongling;ZHANG Hua;Central Laboratory,Guizhou Provincial People's Hospital;Clinical Laboratory,Guizhou Provincial People's Hospital;Department of Cadiovascular Medicine,Affiliated Hospital of Guizhou Medical University;

摘要(Abstract):

目的:探讨结核感染T细胞斑点试验(T-SPOT.TB)对疑似结核病例的辅助诊断价值。方法:收集3 586例T-SPOT.TB的检测结果,将T-SPOT.TB检测结果与确诊结果进行比较,分析T-SPOT.TB的诊断效能;对确诊结核的病例按年龄进行分组,比较T-SPOT.TB检测诊断不同年龄段结核患者的敏感度、特异度;结核特异性抗原刺激后,比较不同年龄段结核病患者斑点形成个数(SFCs),比较不同结核病类型(肺内结核及肺外结核)T-SPOT.TB检测结果的敏感度。结果:T-SPOT.TB对疑似结核患者诊断的敏感度为85.3%,特异度为61.9%,阳性预测值为34.8%,阴性预测值为94.6%,阳性似然比为5.2,阴性似然比为0.6;不同年龄组中,老年组TSPOT.TB检测敏感度最高为92.3%,其次是未成年组90.7%;特异度是未成年组最高为85.6%,其次是青年组53.9%,各组间灵敏度与特异度两两比较,差异均具有统计学意义(P<0.05);青年组SFCs最高,其次是中年组,组间比较,差异均具有统计学意义(P<0.05);T-SPOT.TB诊断肺内结核组敏感度高于肺外结核(P<0.05)。结论:T-SPOT.TB检测对未成年、青年人群疑似结核病例具有较好的辅助诊断价值。
Objective: To evaluate the value of T-SPOT. TB assays in the diagnosis of tuberculosis patients. Methods: The T-SPOT. TB data of 3586 suspected tuberculosis cases were collected. The results of T-SPOT. TB were compared with confirmation results,and the diagnostic efficacy of T-SPOT.TB. were analyzed,The confirmed tuberculosis cases were divided into different age groups,the sensitivity and specificity of T-SPOT. TB were compared in patients with different ages. After tuberculosis specific antigen stimulation,the number of spots( SFCs) in tuberculosis patients with different ages was compared. The sensitivity of T-SPOT. TB in different types of tuberculosis( pulmonary tuberculosis and extrapulmonary tuberculosis) was compared. Results: The sensitivity,specificity,positive predictive value,negative predictive value,positive likelihood ratio and negative likelihood ratio of the TSPOT. TB in diagnosis of tuberculosis were 85. 3%,61. 9%,34. 8%,94. 6%,5. 2 and 0. 6 respectively. The sensitivity of T-SPOT. TB assay was highest in the elderly patients( 92. 3%),followed by underage patients( 90. 7%),the specificity of T-SPOT. TB assay was highest in underage patients( 85.6%),followed by the young patients( 53. 9%),compared between each two groups,the differences were statistically significant( P < 0. 05). SFCs were highest in the young patients,followed by middleage patients,the differences were statistically significant( P < 0. 05). The sensitivity of T-SPOT. TB detection in patients with pulmonary tuberculosis was higher than that of patients with extrapulmonary tuberculosis( P < 0. 05). Conclusion: T-SPOT. TB examination has better auxiliary diagnostic value for suspected tuberculosis cases of underage and young patients.

关键词(KeyWords): 结核;γ干扰素;T细胞斑点试验;感染;诊断
tuberculosis;interforen-γ;T cell enzyme-linked immunospot assay;infection;diagnosis

Abstract:

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基金项目(Foundation): 贵州省科技厅院士工作基金资助项目[黔科合院士站(2015)4015]

作者(Author): 罗振华;胡方芳;李伟;成荣;杨斌;金婷婷;李红凌;张华;
LUO Zhenhua;HU Fangfang;Li Wei;CHENG Rong;YANG Bin;JIN Tingting;LI Hongling;ZHANG Hua;Central Laboratory,Guizhou Provincial People's Hospital;Clinical Laboratory,Guizhou Provincial People's Hospital;Department of Cadiovascular Medicine,Affiliated Hospital of Guizhou Medical University;

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DOI: 10.19367/j.cnki.1000-2707.2017.08.013

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