结核感染T细胞斑点试验在结核病患者诊断中的应用

Application of T-SPOT.TB assay in diagnosis of tuberculosis

目的:探讨结核感染T细胞斑点(T-SPOT.TB)试验在结核病患者诊断中的应用价值。方法:274例疑似结核病患者作为研究对象,均进行T-SPOT.TB检测和结核菌素(PPD)检测,以细菌学检查以及影像学检查进行确诊,比较两种检测方法的诊断价值。结果:TSPOT.TB检测结核病患者的准确率(243例,88.69%)明显高于PPD(192例,70.07%),差异有统计学意义(P<0.05);并且T-SPOT.TB检测结核病患者的灵敏度(90.73%)、特异度(82.61%)、约登指数(0.733)、阳性预测值(93.94%)和阴性预测值(75.00%)均高于PPD检测(分别为74.15%、57.97%、0.321、83.98%和43.01%)。结论:T-SPOT.TB检测在结核病患者诊断中的应用价值高于PPD检测价值。

Objective： To explore the application values of T-SPOT. TB assay in diagnosis of tuberculosis. Methods： 274 pa-tients with suspected tuberculosis were selected as the objects of study. All patients were examined by T-SPOT. TB assay and PPD as-say, and then the bacteriological and imaging examinations were used to diagnose tuberculosis. The diagnostic values of T-SPOT. TB assay and PPD assay were compared. Results： The accuracy of T-SPOT. TB assay （2 4 3 cases, 88. 69% ） was significantly higher than that of PPD assay （192 cases, 70. 07%） for tuberculosis diagnosis, and the difference was statistically significant （ P 〈0. 0 5 ） . The sensitivity （90. 73% ） , specificity （82. 61% ） , Youden index （0. 733） , positive predictive value （93. 94% ） and negative pre-dictive value （75.00% ） of T-SPOT. TB assay were higher than those of PPD assay （74. 15%, 57. 97%, 0. 321, 83. 98% and 43.01%）. Conclusions ： The examination method of T-SPOT. TB assay has a higher diagnostic value for tuberculosis than PPD assay.