【摘要】 目的探讨结核感染T细胞酶联免疫斑点试验(T-SPOT.TB)在肺结核及肺外结核诊断中的价值。方法 T-SPOT.TB检测55例活动性肺结核患者、30例肺外结核患者、14例肺部病变非肺结核者、9例肺外非结核性疾病者和12例健康体检者外周血结核抗原特异性的分泌IFN-γ的T细胞频率。结果肺结核组T-SPOT.TB阳性率明显高于肺部病变非肺结核组和健康对照组,肺外结核组阳性率明显高于肺部病变非肺结核组和健康对照组,差异有统计学意义(P<0.01)。T-SPOT.TB检测对菌阳肺结核、菌阴肺结核和肺外结核的诊断敏感度分别为88.57%、80.00%和93.33%,诊断特异度为85.71%、85.71%和88.89%,阳性预测值分别为93.94%、88.89%和96.55%,阴性预测值为75.00%、75.00%和80.00%。菌阴肺结核组与菌阳肺结核组之间比较,T-SPOT.TB诊断效能差异无统计学意义(P>0.05);肺外结核组与菌阴肺结核和菌阳肺结核之间比较,T-SPOT.TB诊断效能差异均无统计学意义(P>0.05)。结论 T-SPOT.TB诊断结核感染方面具有良好的敏感性和特异性,在肺外结核和菌阴肺结核的诊断与鉴别诊断方面有重要临床应用价值。更多还原

【Abstract】 Objective To investigate the diagnostic value of T-cell Enzyme-linked immunospot assay(T-SPOT.TB) in patients with pulmonary tuberculosis and extrapulmonary tuberculosis.Methods T-SPOT.TB was used to detect T-cell frequency in 55 patients with active tuberculosis,14 case-controls with non-tuberculosis lung diseases,9 case-controls with non-tuberculosis extrapulmonary diseases and 12 healthy controls.Results The positive rate of T-SPOT.TB was significantly higher in the patients with pulmonary tuberculosis and extrapulmonary tuberculosis than controls(P<0.01).The sensitivity of T-SPOT.TB assay was 88.57%,80.00% and 93.33%,the specificity was 85.71%,85.71% and 88.89%,the positive predictive value was 93.94%,88.89% and 96.55%,and the negative predictive value was 75.00%,75.00% and 80.00% in sputum smear-positive tuberculosis,sputum smear-negative tuberculosis and extrapulmonary tuberculosis,respectively.There was no statistical difference between extrapulmonary tuberculosis and sputum smear-positive tuberculosis and smear-negative tuberculosis(P>0.05).Conclusion T-SPOT.TB assay possesse satisfactory sensitivity and specificity to diagnose tuberculosis infection and has an important clinical value in the diagnosis of extrapulmonary tuberculosis and sputum-negative pulmonary tuberculosis.更多还原