结核感染T细胞斑点试验在疑似肺结核患者快速诊断中的应用

Clinical Application of a T-SPOT.TB Test for Diagnosis of Pulmonary Tuberculosis in Suspected Patients

目的探讨结核感染T细胞斑点试验(T-SPOT.TB)在疑似肺结核患者中的应用价值。方法对98例疑似肺结核患者和53例健康对照组人群进行T-SPOT.TB检测,并与TB-Ab,ESR,CPR结果进行对比分析。结果①98例疑似肺结核病患者T-SPOT.TB阳性38例,阳性检出率为38.74%,其中31例临床最终确诊为肺结核,诊断敏感性为81.58%(31/38);53例健康对照组人群T-SPOT.TB阳性3例,阳性检出率为5.60%,特异性为94.34%(50/53)。②98例疑似肺结核患者TB-Ab阳性21例,阳性率为21.43%,T-SPOT.TB阳性组和T-SPOT.TB阴性组患者TB-Ab阳性检出率分别为21.05%和21.67%,差异无统计学意义(P>0.05);31例确诊的肺结核患者中TB-Ab阳性6例,诊断敏感性仅为19.35%,显著低于T-SPOT.TB诊断敏感性81.58%(x^2=32.91,P<0.01)。③T-SPOT.TB阳性和阴性组与ESR,CRP水平比较,差异均无统计学意义(P>0.05)。结论 T-SPOT.TB试验是一种重要的肺结核病的辅助诊断技术,具有较高的敏感性和特异性,有助于结核病的快速诊断和治疗。

Objective To investigate the usefulness of the T-cell enzyme-linked immunospot assay （ T-SPOT.TB） for diagnosis of pulmonary tuberculosis in suspected patients.Methods Ninety-eight patients with suspected pulmonary tuberculosis（patient group） and fifty-three healthy subjects（controls） were enrolled.The T-SPOT.TB test, TB-Ab,ESR and CRP were performed for all subjects.Results ①Thirty-eight cases were T-SPOT.TB-positive in sus-pected pulmonary tuberculosis group,the positive rate was 38.74%（38/98） ,of which 31 cases were finally diagnosed as pulmonary tuberculosis,the diagnostic sensitivity was 81.58%（31/38）.Three cases were T-SPOT.TB-positive in health-y controls,the positive rate was 5.60%（3/53）,the specificity of T-SPOT.TB test was 94.34%（50/53）.②Twenty-one cases were TB-Ab-positive in suspected pulmonary tuberculosis group,the positive rate was 21.43%（21/98）,and TB-Ab-positive rates were 21.05% and 21.67% in the T-SPOT.TB -positive and T-SPOT,respectively.In TB -negative groups,there was no significant differences（P〉0.05）.Six cases were TB-Ab-positive in 31 patients diagnosed as pul-monary tuberculosis,the diagnostic sensitivity was only 19.35%（6/31）,it is significantly lower than that of T-SPOT.T test（81.58%）（χ2 =32.91,P〈0.01）.③There were no significant differences between the levels of ESR and CRP in the T-SPOT.TB positive and negative patient group（P〉0.05）.Conclusion T-SPOT.TB test is an important supple-mentary method for diagnosis of pulmonary tuberculosis,with higher sensitivity and stronger specificity.It would be help-ful for the rapid diagnosis and treatment for tuberculosis.