结核感染T细胞斑点实验在临床早期诊断菌阴肺结核中的应用价值

Application Values of T-SPOT.TB in Clinical Rapid Diagnosis of Tuberculosis

目的探讨结核T细胞斑点实验在诊断菌阴肺结核的应用价值。方法选取本院(2017年1月至2018年6月)收治的51例最终确诊(确诊方法包括细菌学培养、组织学及临床过程,临床过程主要指临床特征、影像学分析、抗结核化疗的反应性)为菌阴肺结核的患者为菌阴结核组,随机选取同期非结核患者40例作为非结核组。两组分别采用结核感染T细胞斑点实验(T-SPOT.TB)、结核抗体检测(TB-Ab)、结核菌核酸检测(TB-DNA)比对其结果。结果3种方法在敏感度比较上,T-SPOT.TB的敏感度最高,痰TB-DNA次之,TB-Ab的敏感度最低。在特异度上比较,TB-Ab的特异度最高,T-SPOT.TB次之,痰TB-DNA最低。而在ROC曲线分析中,T-SPOT.TB的AUC最高,为0.896.痰TB-DNA其次,为0.772。痰涂片最低,为0.698。结论T-SPOT.TB能快速及准确地判断是否存在结核感染,且为无创检查,能进一步辅助菌阴肺结核的诊断及指导治疗。

Objective This paper aims to explore the application value of tuberculosis-specific enzyme-linked immunospot assay(T-SPOT.TB)in the diagnosis of tuberculosis.Methods Fifty one patients with tuberculosis(TB)admitted to Wuxi No.5 People′s Hospital,Wuxi,China from June 2015 to June 2017 were selected as the TB group,and 40 patients without tuberculosis admitted in the same period were randomly selected as the non-TB group.Patients in the two groups received T-SPOT.TB,TB antibody(TB-Ab)test and mycobacterium TB deoxyribonucleic acid(TB-DNA)test,and the results were compared.Results Comparisons of the sensitivity of the three methods showed that the sensitivity of T-SPOT.TB was the highest,followed by TB-DNA from sputum samples,and that of TB-Ab was the lowest.The specificity of TB-Ab was the highest,followed by T-SPOT.TB,and that of TB-DNA from sputum samples was the lowest.In the receiver operating characteristic(ROC)curve analysis,the area under curve(AUC)of T-SPOT.TB(0.896)was the highest,followed by TB-DNA from sputum samples(0.772),and that of sputum smears(0.698)was the lowest.Conclusion.