T-spot.TB在克罗恩病和肠结核鉴别诊断中的价值

The Value of T-spot. TB in Differential Diagnosis of Crohn's Disease and Intestinal Tuberculosis

目的探讨结核杆菌T细胞斑点试验(T-spot.TB)在克罗恩病和肠结核鉴别诊断中的价值。方法对北京大学深圳医院2010年1月至2012年8月收治的35例克罗恩病和37例肠结核患者进行T-spot.TB、糖类抗原125(CA125)测定,比较两种检测方法检测克罗恩病和肠结核的阳性率,并比较T-spot.TB和血CA125对克罗恩病和肠结核的鉴别诊断价值。结果肠结核组T-spot.TB、血CA125检测阳性率分别为91.9%(34/37)和78.4%(29/38),均显著高于克罗恩病组的8.6%(3/37)和21.6%(9/38)(P<0.05),T-spot.TB鉴别克罗恩病和肠结核的灵敏度、特异度、准确度、阳性预测值、阴性预测值分别为9.19%、91.4%、91.7%、91.9%和91.4%,均高于血CA125检测。结论 T-spot.TB方便快捷,敏感性和特异性高,在克罗恩病和肠结核的鉴别诊断中具有重要价值。

Objective To evaluate the value of of T-cell spot. TB for differential diagnosis of Crohn＇s disease and intestinal tuberculosis（ITB）. Methods A total of 35 patients with CD and 37 patients with ITB admitted to Peking University Shenzhen Hospital from Jan. 2010 to Aug. 2012 were performed the T-cell spot of tuberculosis test （T-spot. TB） , and carbohydrate antigen 125 （CA125） test, and the positive rate of the two detection methods on CD and ITB were compared,and the different value of T-spot. TB and blood CA125 in the differential diagnosis of CD and ITB were compared. Results The positive rate of T-spot. TB and blood CA125 of the inteslinal tuberculosis group were 91.9% （34/37） and 78.4% （29/38） , significantly higher than those of the CD group＇s 8.6% （3/37） and 21.6% （9/38） （ P 〈 0.05 ）. The sensitivity, specificity,positive predictive value, and negative predictive value of CD and ITB by T-spot. TB were 9.19% ,91.4% ,91.7% ,91.9% and 91.4%, all higher than those by the CA125 blood test. Conclusion T-spot. TB is convenient and rapid, with high sensitivity and specificity, thus has considerable value in the differential diagnosis of CD and ITB.