T细胞斑点试验、结核蛋白芯片、抗酸染色涂片和结核菌素试验对肺结核病诊断价值的比较

Clinical value of T-SPOT.TB, protein-chip, acid-fast stain smear method and purified protein derivative tuberculin skin testing in diagnosis of tuberculosis

目的对T细胞斑点试验(T-SPOT.TB)、结核蛋白芯片(GCT)、抗酸染色涂片(AFS)及结核菌素试验(PPD)检测结核分枝杆菌的方法进行比较,评价不同方法在肺结核病诊断中的临床应用价值。方法回顾性分析2013年1月-2014年6月湖北省宜昌市第三人民医院收治的疑似肺结核患者206例,其中确诊肺结核患者134例;非结核患者72例。用上述4种方法分别检测206例患者,分析4种方法诊断肺结核病的敏感性、特异性,并比较T-SPOT.TB与GCT、AFS与PPD试验诊断肺结核的准确性。结果 T-SPOT.TB、GCT、AFS及PPD试验检测肺结核的敏感性分别为86.57%、52.24%、31.34%和55.97%;特异性分别为90.28%、81.94%、98.61%和66.67%。结论 T-SPOT.TB与GCT、AFS及PPD试验比较,有简便、快速、敏感性高和特异性强等优点,是临床结核病快速诊断的有效检测方法。

[Objective] To compare T-SPOT.TB with gene chip technology （GCT）, acid-fast stain smear method （AFS） and purified protein derivative tuberculin skin testing （PPD） for detection of tuberculosis in order to evaluate the clinical application value of different methods. [Methods] The results of the above methods were analyzed for 206 pulmonary tuberculosis suspects who were admitted to the Third People＇s Hospital of Yichang from January 2013 to June 2014. Among the suspects, 134 cases were diagnosed as pulmonary tuberculosis, and 72 were as non-puhnonary tuberculosis. All the cases were detected by the above four methods. The sensitivity, specificity and degree of accuracy of the above four methods were analyzed according to the final diagnosis. [Results] The sensitivities of T-SPOT.TB, GCT, AFS and PPD were 86.57%, 52.24%, 31.34% and 55.97%, while their specificities were 90.28%, 81.94%, 98.61% and 66.67%, respec- tively. [Conclusions] Compared with GCT, AFS and PPD, T-SPOT.TB is rapid, sensitive and specific for detecting tuberculosis, which can be taken as a helpful method for early and rapid detection of pulmonary tuberculosis.