T-SPOT.TB在骨与关节结核鉴别诊断中的价值

Value of T-SPOT in Differential Diagnosis on Osteoarticular TB

目的:探讨结核感染T细胞斑点实验(T-SPOT.TB)在骨与关节结核鉴别诊断中的应用价值。方法:通过收集我院骨科2012年3月至2015年6月收治的骨结核患者及非骨结核的骨质破坏患者,统计T-SPOT.TB结果的灵敏度、特异度、假阳性率、假阴性率,同时统计结核抗体上述指标作为对比参考。结果:在本组病例中TSPOT.TB试验灵敏度为91.36%,特异度为100%,经统计学处理P<0.05,T-SPOT.TB检测优于结核抗体检查。结论:T-SPOT.TB检测法对肺外结核病诊断特异性高,对于骨与关节结核病的诊断意义重大,不失为一种可靠的检查手段,但目前价格较贵,不建议作为结核病常规筛查,应该应用于疑难病例的鉴别诊断中。

Objective： To discuss the value of T-SPOT in differential diagnosis on osteoarticular TB. Method： The sensitivity,specificity,false positive rate and false negative rate of T-SPOT in TB was got By collecting and analysing cases of patients admitted in our hospital with bone destruction due to tuberculosis and non-tuberculosis during March 2012 June2015. The pertinent above indications of TB-Ab were recorded for comparison. Results： In whole cases,the sensitivity of T-SPOT-TB test was 91. 36%,with the specificity rate of 100%. The pertinent statistic results showed the superiority of T-SPOT-TB test to TB-Ab（ P〈0. 05）. Conclusion： Of the high diagnosis specificity,T-SPOT TB test is meaningful in diagnosis of osteoarticular TB,which can be regarded as a reliable means of inspection. For its expensive spending,it is recommended in the differential diagnosis of difficult cases other than as a routine inspection.