【作者】 田丽丽； 菅记涌； 王嫩寒； 张洁； 丁北川； 盖亚茹； 武文清； 王甦民；

【Author】 Tian Lili;Jian Jiyong;Wang Nenhan;Zhang Jie;Ding Beichuan;Wu Wenqing;Gai Yaru;Wang Sumin;Beijing Research Institute For Tuberculosis Control;Beijing Shi Ji Tan Hospital;

【机构】 北京结核病控制研究所； 北京世纪坛医院检验科；

【摘要】 目的:研究全血γ-干扰素释放试验(interferon gamma release assay,IGRA)在结核病诊断中的敏感性和特异性,探讨该方法在结核诊断中的应用价值。研究对象、方法:采集北京结核病控制研究所门诊就诊的227名疑似罹患结核病的静脉血进行前瞻性研究,收集患者临床资料,应用酶联免疫斑点法(ELISPOT)检测结核分枝杆菌γ干扰素释放实验(T-SPOT.TB)对结核诊断的敏感性和特异性。结果:227人中,临床确诊罹患结核病87例,其中肺结核78例,肺外结核9例,肺结核中T-spot试验阳性69例,T-spot试验阴性9例;肺外结核中T-spot试验阳性7例,T-spot试验阴性2例。在140例临床确诊未患结核病的人中,T-spot试验阳性29例,T-spot试验阴性111例。T-SPOT.TB在结核诊断中的敏感性为87.4%,特异性为79.3%,假阴性率为12.6%,假阳性率为20.7%,与国内外诸多研究数据相近。结论:T-SPOT.TB在诊断结核方面具有较高的敏感性和特异性,适合作为结核筛检试验,也适用于肺外结核的检测及结核的排除诊断。更多还原

【Abstract】 Objective:Study on the sensitivity and specificity of the whole blood interferon gamma release assay(IGRA),and to explore the application value in the diagnosis of tuberculosis.Methods:A prospective study was performed on collecting blood samples and clinical date from 227 suspected tuberculosis patients.Using the T-spot.TB for detection of the sensitivity and specificity in the diagnosis of tuberculosis.Results:In the 227 patients,87 cases of clinical tuberculosis,including 78 cases of pulmonary tuberculosis and 9 cases of extrapulmonary tuberculosis;In the pulmonary tuberculosis,the positive casea were 69 and the negative cases were 9 by T-spot.TB test;In the extrapulmonary tuberculosis,the positive cases were 7 and the negative cases were 2 by T-spot.TB test.In 140 cases were not suffering from tuberculosis,the positive cases were 29 and the negative cases were 111 by T-spot.TB test.The sensitivity and specificity of T-spot.TB assay were 87.4%and 79.3 % respectively,and the false negative and false positive rate were 12.6% and 20.7 % respectively,similar to many research date.Conclution:T-spot.TB shows higher sensitivity and specificity in the diagnosis of tuberculosis.It is an effective method in tuberculosis screening test.Also suitable the extrap ulmonary tuberculosis screening test and exclude the diagnosis of tuberculosis.更多还原