T-SPOT-TB检测法在结核性脑膜炎早期诊断中的应用分析

Application of T-SPOT-TB Assay in Early Diagnosis of Tuberculous Meningitis

目的探究结核感染T细胞斑点检测法(T-SPOT-TB)在结核性脑膜炎早期诊断中的应用价值。方法选取2014年5月至10月甘孜州人民医院收诊的结核性脑膜炎疑似患者36例进行研究,对患者行T-SPOT-TB检测、脑脊液结核抗体、脑脊液抗酸染色及脑脊液结核杆菌培养试验(金标准)、结核菌素试验检测,观察对比各种检测方法下患者阳性检出率,计算各检测方法灵敏度、特异度及准确度。结果 T-SPOT-TB灵敏度为93.9%,特异度为100%,准确度为97.0%。脑脊液结核抗体检测灵敏度为81.8%,特异度为100%,准确度为90.9%。脑脊液抗酸染色灵敏度为42.4%,特异度为100%,准确度为71.2%。结核菌素试验灵敏度为78.8%,特异度为100%,准确度为89.4%。结论 T-SPOT-TB检测法能够简便、快捷地为结核性脑膜炎患者的诊断提供科学有效的依据,其临床价值高,值得进一步的推广使用。

Objective To explore the value of tuberculosis infection T cell spot test( T-SPOT-TB) assay for tuberculous meningitis in its early diagnosis. Methods Total of 36 cases suspected with tuberculous meningitis in Ganzi People's Hospital of Infectious Diseases Hospital from May to October 2014 were included in the study,and the patients were given T-SPOT-TB detection,CSF TB antibodies,CSF acid-fast staining and CF TB culture test( gold standard),tuberculin test,to observe and compare the positive rate of patients under different test methods. The sensitivity,specificity,and accuracy of each test method were calculated. Results T-SPOT-TB sensitivity was 93. 9%,specificity was 100%,accuracy was 97. 0%. The CSF TB antibody sensitivity was 81. 8%,the specificity was 100%,and the accuracy was 90. 9%. CSF acid-staining sensitivity was 42. 4%,specificity was 100%,accuracy was 71. 2%. The sensitivity of the tuberculin test was 78. 8%,the specificity was 100%,accuracy was 89. 4%. Conclusion T-SPOT-TB assay can simply and quickly provide scientific information for the diagnosis of tuberculous meningitis patients,which has a high clinical value and is worthy of further promotion and use.