【摘要】 目的分析结核分枝杆菌/利福平耐药实时荧光定量核酸扩增检测技术(Xpert Mtb/RIF)、T细胞斑点试验(T-SPOT)和抗酸染色涂片法对不同年龄组可疑肺结核患者的诊断价值。方法选取224例疑似肺结核患者为研究对象,根据年龄分为少年及青年组、中年组和老年组,分别采用Xpert Mtb/RIF、T-SPOT和抗酸染色涂片法对各组患者的肺泡灌洗液或痰液标本进行检测。结果以临床诊断结果为金标准,少年及青年组Xpert Mtb/RIF、T-SPOT和抗酸染色涂片法检测的灵敏度分别为63.2%、63.2%和26.3%,特异度分别为95.5%、90.9%和100.0%;中年组Xpert Mtb/RIF、T-SPOT和抗酸染色涂片法检测的灵敏度分别为43.5%、60.9%和4.3%,特异度分别为93.7%、86.1%和98.7%;老年组Xpert Mtb/RIF、T-SPOT和抗酸染色涂片法检测的灵敏度分别为40.0%、60.0%和20.0%,特异度分别为91.8%、83.7%和98.0%。少年及青年组和中年组Xpert Mtb/RIF和T-SPOT两种检测方法的灵敏度均明显高于抗酸染色涂片法,差异有统计学意义(P<0.05);老年组3种检测方法的灵敏度比较,差异无统计学意义(P>0.05),但抗酸染色涂片法特异度明显高于TSPOT,差异有统计学意义(P<0.05)。结论 Xpert Mtb/RIF和T-SPOT两种方法在少年及青年和中年疑似肺结核患者的诊断中有较明显的优势,对老年疑似肺结核患者的诊断可根据具体情况选择合适的检测方法。更多还原

【Abstract】 Objective To analyze the diagnostic value of Xpert Mtb/RIF,T-SPOT and acid-fast stain smear for different age patients with suspected pulmonary tuberculosis.Methods A total of 224 suspected pulmonary tuberculosis patients were enrolled and divided into three groups including juveniles and youth group,middle-age group and gerontism group.The sputum and bronchoalveolar lavage fluid samples of three groups were examined by Xpert Mtb/RIF,T-SPOT and acid-fast stain smear.Results Taking clinical diagnosis as gold standard,the sensitivity of Xpert Mtb/RIF,T-SPOT and acid-fast stain smear in juveniles and youth group were 63.2%,63.2% and 26.3% respectively,the specificity of Xpert Mtb/RIF,T-SPOT and acid-fast stain smear in juveniles and youth group were 95.5%,90.9% and 100.0% respectively.The sensitivity of Xpert Mtb/RIF,T-SPOT and acid-fast stain smear in middle-age group were 43.5%,60.9%and 4.3%respectively,the specificity of Xpert Mtb/RIF,T-SPOT and acid-fast stain smear in middle-age group were 93.7%,86.1%and 98.7% respectively.The sensitivity of Xpert Mtb/RIF,T-SPOT and acid-fast stain smear in gerontism group were 40.0%,60.0% and 20.0% respectively,the specificity of Xpert Mtb/RIF,T-SPOT and acid-fast stain smear in gerontism group were 91.8%,83.7%and 98.0%respectively.The sensitivity of Xpert Mtb/RIF and T-SPOT were significantly higher than that of acid-fast stain smear both in juveniles and youth group and middle-age group(P<0.05).The sensitivity of three methods in gerontism group has no significant difference(P>0.05),but the specificity of acid-fast stain smear was significantly higher than that of T-SPOT(P<0.05).Conclusion Both Xpert Mtb/RIF and T-SPOT have advantages in pulmonary tuberculosis diagnosis of juveniles,youth and middle-age suspected pulmonary tuberculosis patients.The diagnosis method of pulmona-ry tuberculosis in gerontism pulmonary tuberculosis patients should be selected according to the specific situations.更多还原