T-SPOT.TB测定、PPD试验和结核蛋白芯片对儿童肺结核诊断价值的研究

Study on the diagnostic value of T-SPOT.TB determination,PPD test and tuberculosis protein chip in the children with pulmonary tuberculosis

目的利用T-SPOT.TB测定、结核菌素试验方法(PPD法)及结核蛋白芯片法进行儿童结核分枝杆菌的检测诊断比较,以评价各种不同方法在儿童肺结核诊断中的临床应用价值。方法回顾性分析2015~2017年宜昌市第三人民医院收治的疑似肺结核患儿108例,其中确诊肺结核患儿57例,非结核患儿51例,用上述3种方法分别检测108例患儿,统计分析三种方法在诊断儿童结核病的灵敏度、特异度,并比较T-SPOT.TB与PPD法及结核蛋白芯片法诊断儿童肺结核的准确度。结果 T-SPOT.TB测定法、PPD法及结核蛋白芯片法检测儿童肺结核的灵敏度分别为87.72%、56.14%和52.63%;特异度分别为90.19%、66.67%和82.35%。结论 T-SPOT.TB测定与PPD法及结核蛋白芯片法比较,具有快速、敏感性高和特异性强等优点,是临床儿童结核病快速诊断的有效检测方法。

Objective To compare the application of T-SPOT.TB determination,tuberculin test method(PPD method)and tuberculosis protein chip method for the detection and diagnosis of mycobacterium tuberculosis in children,so as to evaluate the clinical application value of different methods in the diagnosis of pulmonary tuberculosis in children.Methods 108 children patients with suspected tuberculosis who were admitted to Yichang Third People’s Hospital from 2015 to 2017 were retrospectively analyzed.Of these,57 children patients were diagnosed as pulmonary tuberculosis and 51 were non-tuberculosis.The above three methods were used to detect 108 cases of children.The sensitivity and specificity of the three methods in the diagnosis of pediatric tuberculosis were statistically analyzed,and the T-SPOT.TB,PPD methods and tuberculosis protein chip method in the diagnosis of pediatric pulmonary tuberculosis were compared.Results The sensitivity of T-SPOT.TB determination method,PPD method and tuberculosis protein chip method in the detection of pulmonary tuberculosis in children were 87.72%,56.14%and 52.63%respectively;the specificity was 90.19%,66.67%and 82.35%respectively.Conclusion Compared with PPD method and tuberculosis protein chip method,T-SPOT.TB determination method has the advantages of rapidity,high sensitivity and strong specificity.It is an effective clinical detection method for rapid diagnosis of tuberculosis in children.