结核感染T细胞斑点试验诊断肺结核临床价值探讨

Clinical value of T cells spot test of tuberculosis infection for diagnosis of pulmonary tuberculosis

目的对比结核感染T细胞斑点试验(T-SPOT.TB)、皮肤结核菌素试验、结核抗体和痰液或肺泡灌洗液涂片4种方法诊断肺结核的结果,选择临床最有价值的诊断方法。方法选择湖北省襄阳市中医院2010年12月至2012年12月非结核呼吸系统疾病患者48例和同期明确诊断为结核的患者42例为研究对象。对所有患者进行T-SPOT.TB、皮肤结核菌素试验、结核抗体和痰液或肺泡灌洗液涂片,计算并比较各种检查阳性率、敏感度和特异性。结果 T-SPOT.TB的结核抗体敏感性和特异性均高于皮肤结核菌素和痰液及肺泡灌洗液涂片,且具体数值相同;通过两两比较发现,T-SPOT.TB的阳性率均明显高于其他3种试验方法(P<0.05)。结论 T-SPOT.TB诊断结核具有很好的稳定性,值得临床推广使用。

Objective To compare 4 kinds of pulmonary tuberculosis diagnosis method results,including T cells spot test of tuberculosis infection（T-SPOT.TB）,tuberculin skin test,tuberculosis antibody,sputum or bronchoalveolar lavage fluid smear,and choose the most valuable clinical diagnostic method.Methods From December 2010 to December 2012,48 patients with non-tuberculosis respiratory system diseases and 42 patients with definite diagnosis of tuberculosis patients as the research objects were collected in the hospital.T cells spot test of tuberculosis infection,tuberculin skin test,tuberculosis antibody and sputum or bronchoalveolar lavage fluid smear were performed in all patients,the positive rate,sensitivity and specificity was calculated and compared.Results The sensitivity and specificity of T-SPOT.TB,tuberculosis antibodies was higher than that of tuberculin and sputum and bronchoalveolar lavage fluid smear.and with the same numerical values.The positive rate by two two comparison of T-SPOT.TB was higher than the other 3 methods（P〈0.05）.Conclusion The positive rate of T-SPOT.TB in diagnosis of tuberculosis in the highest,the sensitivity and specificity of T-SPOT.TB rank the 2nd in the 4 methods,which has good stability and worthy popularizing.