结核分枝杆菌感染T细胞斑点试验的临床应用价值

结核病与肺部健康杂志 ›› 2013, Vol. 2 ›› Issue (1): 22-24.

结核分枝杆菌感染T细胞斑点试验的临床应用价值

张宜文，王庆，史清明，王东萍，陈艳

230022 合肥,安徽省胸科医院呼吸科(张宜文、陈艳),肿瘤科(史清明)；化验室(王庆、王东萍)

收稿日期:2013-01-28 出版日期:2013-03-30 发布日期:2013-03-30
通信作者: 史清明, Email:shqm0324@163.com

Diagnostic value of T lymphocyte spot assay on tuberculosis

ZHANG Yi-wen^*,WANG Qing, SHI Qing-ming, WANG Dong-ping, CHEN Yan

^*Department of Pneumology Anhui Chest Hospital, Hefei 230022, China

Received:2013-01-28 Online:2013-03-30 Published:2013-03-30
Contact: SHI Qing-ming, Email:shqm0324@163.com

摘要/Abstract

摘要： 目的寻找一种敏感度和特异度都较高的临床诊断方法,以提高结核病的确诊率。方法搜集110例经实验室与临床诊断确诊的患者,采用结核分枝杆菌感染T淋巴细胞斑点试验(T-SPOT.TB),检测其诊断结核病的敏感度和特异度。同时行PPD试验的患者104例。结果66例结核患者中56例T-SPOT.TB检测阳性,敏感度为84.85%;66例中61例作PPD试验,42例为阳性结果,敏感度为68.85%,两者比较差异有统计学意义(χ²=7.76,P<0.05);44例非结核性疾病患者中39例T-SPOT.TB检测阴性,特异度为88.64%;44例中43例作PPD试验,31例阴性,特异度为72.09%,两者比较差异有统计学意义(χ²=4.72,P<0.05)。T-SPOT.TB检测在敏感度、特异度上均显著优于临床常用的PPD。T-SPOT.TB阳性预测值91.80%(56/61)。PPD试验阳性预测值76.36%(42/55)。结论T-SPOT.TB试剂盒在检测结核病诊断方面具有很高的应用价值。

Abstract: Objective To find a way with higher sensitivity and specificity for the diagnosis of tuberculosis (TB).Methods A total of 110 patients were enrolled in this study.The sensitivity and specificity of a T lymphocyte spot assay (T-SPOT.TB) were evaluated in the diagnosis of TB.One hundred and four patients were examined with PPD skin test.Results Of 66 TB patients, 56 were positive with T-SPOT. TB testing, its sensitivity was 84.85%. Forty two of 61 TB cases were PPD positive, its sensitivity was 68.85%. The difference between these two methods have statistical significance(χ²=7.76,P<0.05). Of 44 patients with non-TB diseases, 39 were negative with T-SPOT. TB test, its specificity was 88.64%. Forty three of 44 non-TB cases were examined with PPD skin test, 31 cases were PPD negative, its specificity was 72.09%. Their difference is statistically significant (χ²=4.72,P<0.05). The positive predictive values of T-SPOT.TB assay and PPD skin test were 91.80%(56/61)and 76.36%(42/55), respectively. The sensitivity and specificity of T-SPOT.TB testing were significantly superior to that of PPD skin test.Conclusion T-SPOT.TB assay had higher clinical value on diagnosis of TB.

张宜文，王庆，史清明，王东萍，陈艳. 结核分枝杆菌感染T细胞斑点试验的临床应用价值[J]. 结核病与肺部健康杂志, 2013, 2(1): 22-24.

ZHANG Yi-wen^*,WANG Qing, SHI Qing-ming, WANG Dong-ping, CHEN Yan. Diagnostic value of T lymphocyte spot assay on tuberculosis[J]. Journal of Tuberculosis and Lung Health, 2013, 2(1): 22-24.

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