T细胞斑点试验检测在肺外结核诊断中的应用价值

Application value of T cell spot test in the diagnosis of extrapulmonary tuberculosis

目的探讨肺外结核应用T细胞斑点试验检测的诊断价值。方法选取我院2013年1月~2016年8月收治的200例疑似肺外结核患者作为研究对象,所有患者均接受结核抗体检测、T细胞斑点试验,以临床确诊结果作为对照,计算并比较结核抗体检测、T细胞斑点试验对肺外结核的诊断灵敏度、特异度、准确度。结果 T细胞斑点试验对肺外结核的诊断灵敏度、特异度、准确度分别为96.45%、93.55%、96.00%,与结核抗体检测的诊断灵敏度(53.85%)、特异度(64.52%)、准确度(55.50%)比较,差异有统计学意义(P<0.05)。T细胞斑点试验诊断肺外结核的结果与临床确诊结果之间的一致性为Kappa=0.725,而结核抗体检测与临床确诊结果之间的一致性为Kappa=0.435。结论采用T细胞斑点试验可对肺外结核完成快速、准确的诊断,在肺外结核诊断中具有显著的诊断价值,可作为肺外结核的重要辅助诊断方法。

Objective To discuss the diagnostic value of T cell spot test in the diagnosis of. pulmonary tuberculosis. Methods 200 cases of suspected pulmonary tuberculosis from January 2013 to August 2016 in our hospital were selected as the object of study review,all patients were detected by T cell spot test and tuberculosis antibody detection, clinical diagnosis result was set as reference,the diagnostic sensitivity,specificity and accuracy of extrapulmonary tuber- culosis were calculated and compared between tuberculosis antibody and T cell spot test.Results The diagnostic sensitivity,specificity and accuracy of T cells spot test in extrapulmonary tuberculosis were 96.45%,93.55% and 96.00%,and compared with the sensitivity （53.85%）,specificity （64.52%） and accuracy （55.50%）in the diagnosis of tuberculosis antibody detection,the difference was statistically significant （P〈0.05）.The consistency between the results of the T cell spot test for the diagnosis of extrapulmonary tuberculosis and the clinical outcome was Kappa=0.725,and the agreement between the results of TB antibody detection and clinical diagnosis was Kappa=0.435.Conclusion The T cell spot test can be used for rapid and accurate diagnosis of pulmonary tuberculosis,it has significant diagnostic value in the diagnosis of pulmonary tuberculosis,which can be used as an important auxiliary diagnosis method for the diagnosis of pulmonary tuberculosis.