T细胞斑点试验在结核病诊断中的效果分析

Clinical Value of T-SOPT. TB in Diagnosis of Tuberculosis

目的探讨T细胞斑点试验在结核病诊断中的价值。方法收集2012年7月至2015年3月海口市人民医院收治的疑似结核病患者476例,分别采用结核感染T细胞斑试验(T-SOPT.TB)和结核菌素皮肤试验(TST)检测,并与最终临床诊断结果进行对比;评价T-SOPT.TB在结核感染中的诊断价值。结果 476例受试对象中临床确诊为结核病的患者为194例,其中肺结核122例、肺外结核58例、结核性胸膜炎14例。最终临床检查结核感染阳性检出率为40.8%(194/476),T-SOPT.TB阳性检出率为39.9%(190/476),TST阳性检出率为45.4%(216/476);以最终实验室细菌学或组织学检查作为金标准,T-SOPT.TB检测特异度为98.9%(279/282),灵敏度为96.4%(187/194),准确度为97.9%(466/476);T-SOPT.TB检测Kappa值为0.956,两者一致性良好;TST检测Kappa值为0.504,两者一致性中等。结论 T-SOPT.TB对结核感染的诊断价值优于TST,具有较高的特异度、灵敏度和准确度;对疑似结核感染的患者快速、准确诊断具有重要的参考价值。

Objective To explore the clinical value of T-SOPT. TB in diagnosis of tuberculosis.Methods A total of 476 suspected tuberculosis patients were selected in Haikou City People＇s Hospital from Jul. 2012 to Mar. 2015,T-SOPT. TB and TST methods were used for dianosis,and the results were compared with the final clinical diagnosis results,and the diagnostic value of T-SOPT. TB in tuberculosis was evaluated by SPSS 21. 0. Results Among the 476 subjects,194 cases were diagnosed as tuberculosis,122 cases of pulmonary tuberculosis,58 cases of extrapulmonary tuberculosis,14 cases of tuberculous pleurisy. The final clinical examination of tuberculosis infection positive rate was 40. 8%（ 194 /476）,the positive rate of T-SOPT. TB was 39. 9%（ 190 /476）,the positive rate of TST was 45. 4%（ 216 /476）. The final laboratory bacteriological or histological examination as the gold standard,T-SOPT. TB detection specificity was 98. 9%（ 279 /282）,sensitivity was 96. 4%（ 187 /194）,the accuracy was 97. 9%（ 466 /476）. Compared final clinical examination results,T-SOPT. TB test Kappa value was 0. 956,with good consistency; TST detection Kappa value was 0. 504,with mediate consistency. Conclusion The value of T-SOPT. TB in diagnosis of tuberculosis infection is better than TST,with the advantages of high specificity,sensitivity and accuracy,thus is of important reference value of rapid,accurate diagnosis for the patients with suspected tuberculosis infection.