T细胞斑点试验在骨关节结核诊断中的应用价值研究

Application of T cell spot test in diagnosis of osteoarticular tuberculosis

目的探讨T-SPOT.TB应用于骨关节结核诊断中的价值。方法本研究采用回顾性分析方法,对各组研究对象的一般临床资料、T-SPOT.TB、ESR、结核抗体等方法的检验诊断性能进行比较,研究T-SPOT.TB对骨关节结核感染的诊断价值。结果骨关节结核组抗原A(ESAT-6)和抗原B(CFP-10)检测阳性率分别为75.8%和72.4%;T-SPOT.TB的敏感度、特异度、阳性预测值、阴性预测值、诊断准确率分别为82.7%、85.2%、88.8%、82.7%、85.7%,均显著高于结核抗体和血沉;通过ROC曲线分析,T-SPOT.TB抗原A和抗原B的ROC曲线下面积(AUC)分别为0.869(95%CI:0.806~0.933)和0.881(95%CI:0.819~0.944),截断值分别为5.5和4.5,对应的敏感度分别为79.4%和85.0%,特异度分别为88.7%和85.3%。结论 T-SPOT.TB在骨关节结核感染的诊断中有较高的应用价值。

Objective To explore the diagnostic value of T-SPOT.TB in osteoarticular tuberculosis. Methods Using the retrospective analysis method, the clinical data, T-SPOT.TB, ESR, and other indicators of tuberculosis antibody were collected and compared to test the diagnostic performance of several methods. Through comparative analysis, the diagnostic value of T-SPOT.TB for osteoarticular tuberculosis was studied. Results The positive rates of antigen A(ESAT-6) and antigen B(CFP-10) in osteoarticular tuberculosis group were 75.8% and 72.4%. The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of T-SPOT.TB were 82.7%, 85.2%, 88.8%, 82.7%, 85.7%, which were significantly higher than those of tuberculosis antibody and ESR. Through the analysis of ROC curve, ROC curve area of T-SPOT.TB antigen A and B antigen of osteoarticular tuberculosis diagnosed by(AUC) 0.869(95%CI: 0.806-0.933) and 0.881(95%CI: 0.819-0.944), the cut-off value was respectively 5.5 and 4.5, the sensitivity was respectively 79.4% and 85.0%, the specificity was respectively 88.7% and 85.3%. Conclusion T-SPOT.TB is of high value in the diagnosis of tuberculosis infection of bone and joint.