结核感染T细胞斑点试验在疑似结核病患者诊断中的价值

The diagnostic value of T-cell spot test for the diagnosis of suspected tuberculosis

目的探讨结核感染T细胞斑点试验在结核病患者诊断中的价值。方法对2012年4月至2013年4月沈阳市胸科医院收治的结核病疑似患者100例的临床资料进行回顾性分析。根据诊断情况将患者分为肺结核组、肺外结核组、非结核病组,记录各组患者抗结核治疗前T-SOPT.TB和TST试验检测结果,比较结核病患者抗结核治疗前后抗原A和抗原B特异性斑点数的变化。结果肺结核组T-SOPT.TB试验敏感度、特异度、阴性似然比、阳性似然比分别为86.96%、95.65%、0.007、28.396,TST试验敏感度、特异度、阴性似然比、阳性似然比分别为69.57%、65.22%、0.371、5.438;肺外结核组T-SOPT.TB试验敏感度、特异度、阴性似然比、阳性似然比分别为83.78%、91.89%、0.009、24.482,TST试验敏感度、特异度、阴性似然比、阳性似然比分别为67.57%、64.86%、0.194、3.128;非结核病T-SOPT.TB试验敏感度、特异度、阴性似然比、阳性似然比分别为7.50%、15.00%、0.011、26.714,TST试验敏感度、特异度、阴性似然比、阳性似然比分别为5.00%、12.50%、0.245、4.379。60例结核病患者抗结核治疗前抗原A特异性斑点和抗原B特异性斑点分别为98、49,抗结核治疗后抗原A特异性斑点和抗原B特异性斑点分别为46、18。抗结核治疗前后患者T细胞斑点试验结果比较,差异有统计学意义(P<0.05)。结论 T-SOPT.TB在诊断结核病患者中有较好的临床应用价值,敏感度和特异度较高。

Objective To investigate the T cell spot test in the diagnosis of tuberculosis patients. Methods Clinical data of 100 cases of suspected tuberculosis from April 2012 to April 2013 were analyzed retrospectively. According to the diagnosis of tuberculosis, cases were divided into TB group, extrapulmonary tuberculosis group and the non-tuberculosis group. T-SOW. TB and TST testing result were recorded before and after anti-TB treatment. Antigen A and antigen B changes were compared. Results The sensitivity, specificity, and negative likelihood ratio, positive likelihood ratio of the T-SOPT.TB testing results of the TB group were 86.96%, 95.65%, 0.007 and 28.396, respectively; the sensitivity, specificity, and negative likelihood ratio, positive likelihood ratio of the TST testing results were 69.57%, 65.22% respectively, 0.371 and 5.438, respectively. For the extrapulmonary tuberculosis group, the T-SOPT.TB testing result sensitivity, specificity, and negative hkelihood ratio, and positive likelihood ratio were 83.78%, 91.89%, 0.009 and 24.482, respectively; TST testing result sensitivity, specificity, and negative likelihood ratio, and positive likelihood ratio were 67.57%, 64.86%, 0.194 and 3.128, respectively. For the non-tuberculosis T-SOPT.TB testing result sensitivity, specificity, and negative likelihood ratio, and positive likelihood ratio was 7.50%, 15.00%, 0.011 were 26.714, respectively; TST testing result sensitivity, specificity, and negative likelihood ratio, and positive likelihood ratio were 5.00%, 12.50%, respectively, 0.245 and 4.379, respectively. 60 cases of TB patients before treatment, A antigen-specific spots and B antigen-specific spots were 98 and 49, respectively ; after anti-TB treatment, A antigen-specific and B antigen-specific spots were 46,18,respectively.The differences between before and after treatment were significant （P〈0.05）. Conclusion T-SPOT.TB has better clinical value in the diagnosis of tuberculosis in patients with high sensitivity and specificity.