T-SPOT.TB试验在活动性结核病诊断中的应用价值

Evaluation of T-SPOT.TB in the diagnosis of active tuberculosis

目的评价T细胞酶联免疫斑点试验(T-SPOT.TB)在活动性结核病诊断中的应用价值。方法收集我院2016年1~6月结核门诊就诊的200例疑似活动性结核病的病例,对其就诊时的T细胞酶联免疫斑点试验(T-SPOT.TB)、抗结核抗体(TB-Ab)试验、抗酸染色3种检查的结果进行回顾性分析,以最终临床诊断为判断依据,比较3种方法对活动性结核病诊断的灵敏度和特异度。结果 200例疑似结核病患者最终确诊为结核病110例,非结核病90例。T-SPOT.TB、TB-Ab、抗酸染色的灵敏度分别为94.55%、40.00%、10.91%,两两比较差异均有统计学意义(P<0.01)。

Objective To evaluate the value of T-SPOT.TB in the diagnosis of active tuberculosis. Methods A total of 200 suspected patients with active tuberculosis from Jan to Jun 2016 in our hospital were enrolled in this study. T-SPOT.TB, TB-Ab and acid-fast staining were performed in all patients. According to the results of clinical diagnosis, the sensitivity and specificity of these methods were calculated and compared. Results There were 110 patients diagnosed as active tuberculosis finally. The sensitivity of T-SPOT.TB, TB-Ab and acid-fast staining was 94.55%,40.00%,10.91% respectively. The differences among these methods were statistically significant（P〈0.01）. The specificity of T-SPOT.TB, TB-Ab and acid-fast staining was 77.78%,84.44%,100.00% respectively, there was no significant difference between T-SPOT.TB and TB-Ab（P〉0.05）. Acid-fast staining respectively compared with the other two methods, the difference was statistically significant（P〈0.01）. Conclusion T-SPOT.TB has high sensitivity, so it can be the screening index in rapid auxiliary diagnosis of active tuberculosis.