结核感染T细胞斑点试验诊断肠结核价值研究

Diagnostic value of T-SPOT. TB in intestinal tuberculosis

目的评估结核感染T细胞斑点试验(T-SPOT.TB)对肠结核的诊断价值。方法对2012年4月至2013年12月中南大学湘雅二医院疑似或待排的86例肠结核患者进行T-SPOT.TB及结核菌素试验(TST),比较二者对肠结核诊断的灵敏度、特异度、阳性预测值(PPV)、阴性预测值(NPV),并做ROC曲线分析。结果 T-SPOT.TB诊断肠结核的灵敏度、特异度、PPV和NPV分别为86.2%、92.5%、86.2%和92.5%,高于TST的58.6%、73.6%、54.8%和76.5%,差异有统计学意义(P<0.05),T-SPOT.TB的曲线下面积高于TST。结论 T-SPOT.TB具有较高的灵敏度及特异度,对肠结核具有重要诊断价值,较TST更适于肠结核筛检。

Objective To assess the value of T-SPOT. TB in the diagnosis of intestinal tuberculosis. Methods A total of86 patients with suspected intestinal tuberculosis were enrolled in our hospital from April 2012 to December 2013. T-SPOT.TB and tuberculin skin test（ TST） were both administered in each patient and clinical data were collected,compared and analyzed. Results T-SPOT. TB was significantly superior to TST in sensitivity（ 86. 2% vs 58. 6%,P〈0. 05）,specificity（ 92. 5% vs 73. 6%,P〈0. 05）,positive predictive value（ 86. 2% vs 54. 8%,P〈0. 05）,and negative predictive value（ 92. 5% vs 76. 5%,P〈0. 05）,and the area under ROC curve of T-SPOT. TB is larger than TST. Conclusion T-SPOT.TB has a higher sensitivity and specificity,and a greater value in the diagnosis of intestinal tuberculosis,which is more suitable for screening intestinal tuberculosis than TST.