PPD试验、T-SPOT.TB及TB-ab检测对活动性结核病的诊断价值

Diagnosis value of PPD test,T-SPOT.TB and TB-ab detection in active tuberculosis

目的分析PPD试验、T-SPOT.TB及TB-ab检测对活动性肺结核病的诊断价值。方法选择我院呼吸内科收治的46例疑似活动性肺结核患者,所有患者均行PPD试验、T-SPOT.TB及TB-ab检测。回顾性分析患者的临床资料和检测结果,比较三种方法的诊断准确率。结果 46例患者最终经病理诊断确诊38例为活动性结核病。三种检测方法的诊断准确率分别为89.13%、95.65%、84.78%,T-SPOT.TB检测的准确率显著高于其他两种方法 (P<0.05)。三种检测方法的敏感性分别为92.11%、97.36%、89.47%,特异性分别为75.00%、87.5.0%、62.5.0%,其中T-SPOT.TB的特异性和敏感性最高。结论 T-SPOT.TB检测活动性结核病具有较高的准确率、敏感性和特异性,尽管其存在一定的假阳性,但对于排除活动性结核病有巨大的价值。

Objective To analyze the diagnostic value of PPD, T-SPOT.TB and TB-ab in active tuberculosis. Methods Forty-six patients suspected active tuberculosis admitted to the respiratory department of our hospital were selected, and all patients underwent PPD, T-SPOT.TB and TB-ab detection. The clinical data and test results were retrospectively analyzed,and the diagnostic accuracy of the three methods were compared. Results In 46 cases, 38 cases were diagnosed as active tuberculosis by pathological diagnosis. The diagnostic accuracy of the three methods were 89.13%, 95.65% and 84.78%, respectively; the accuracy of T-SPOT.TB detection was significantly higher than that of the another two methods（P〈0.05）.The sensitivity of the three detection methods were 92.11%, 97.36%, 89.47%; and the specificity were 75.00%, 87.50%and 62.50%, respectively. The specificity and sensitivity of the T-SPOT.TB were the highest. Conclusion T-SPOT.TB detection has high diagnostic accuracy, sensitivity and specificity in the diagnosis of active tuberculosis. Although it has some false positives, it has great value for excluding active tuberculosis.