T-SPOT.TB技术在菌阴肺结核诊断中的意义

Value of T-cell enzyme-linked immunospot assay in diagnosis of smear-negative pulmonary tuberculosis

目的探讨T细胞斑点试验(T-SPOT.TB)技术在菌阴肺结核诊断中的意义。方法收集40例菌阴肺结核患者作为实验组,32例其他肺部疾病患者作为对照组。采用T-SPOT.TB技术分别对两组患者外周血特异性T淋巴细胞进行检测,同时进行结核菌素(PPD)试验、血清结核抗体(Mtb-AB)检测。结果实验组T-SPOT.TB阳性率为87.5%(35/40),明显高于对照组[15.6%(5/32)],差异有统计学意义(P<0.01)。实验组T-SPOT.TB阳性率明显高于PPD试验[37.5%(15/40)]、Mtb-AB[47.5%(19/40)]的阳性率(P<0.01);T-SPOT.TB在对照组中的阴性率为84.4%(27/32),低于PPD试验[90.6%(29/32)]及Mtb-AB[87.5%(28/32)]的阴性率,但比较差异未见统计学意义(P>0.05)。结论 T-SPOT.TB检测特异度和敏感度均要优于PPD试验及结核抗体检测;T-SPOT.TB技术可用于菌阴肺结核的辅助诊断,具有一定的临床应用价值。

Objective To investigate the value of T-cell enzyme-linked immunospot assay（ T-SPOT. TB）in diagnosis of smear-negative pulmonary tuberculosis. Methods Forty patients with smear-negative pulmonary tuberculosis were selected as the experiment group and 32 patients with other pulmonary diseases were selected as control group. T-SPOT. TB was used to de-tect Mycobacterium tuberculosis antigen specific T cells in blood samples of the two groups,and the conventional PPD skin test and serum tuberculosis antibody were performed at the same time. Results By the T-SOPT. TB assay,the positive rate in exper-iment group was 87. 5%（35 / 40）,which was significantly higher than that of control group[15. 6%（5 / 32）]（P 0. 05）. Conclusion T-SPOT. TB assay is superior to PPD test and serum antibody in specificity and sensitivity. It can be used to assist in diagnosis of smear-negative pulmonary tu-berculosis.