结核IgG抗体检测、T-SPOT及痰结核分枝杆菌核酸检测对骨关节结核的诊断价值

The Diagnostic Value of Tuberculosis IgG Antibody Detection,T-SPOT and Sputum Mycobacterium Tuberculosis Nucleic Acid Detection for Osteoarticular Tuberculosis

目的探讨结核分枝杆菌IgG抗体(IgG抗体)检测、结核感染T淋巴细胞斑点试验(T-SPOT)及痰结核分枝杆菌核酸PCR检测(TB-DNA)对诊断骨关节结核的临床价值。方法回顾性分析2017年1月~2018年10月在我科确诊为骨关节结核患者,共196例,另选取同时期非结核患者作为对照组,共69例。所有患者都采用血清结核IgG抗体、外周血T-SPOT及痰TB-DNA三种检测技术。比较三种检测技术的敏感性和特异性,评估临床价值。结果在196例骨关节结核患者中,三种检测技术敏感性T-SPOT>结核IgG抗体>痰TB-DNA,差异有统计学意义(P<0.05);在69例非结核患者中,三种检测技术特异性痰TB-DNA>结核IgG抗体>T-SPOT,差异有统计学意义(P<0.05)。结论三种检测技术的敏感性和特异性存在差异,其中T-SPOT检测敏感性最高,痰TB-DNA特异性最高,快速诊断骨关节结核还需结合多种检测技术。

Objective To explore the clinical value of Mycobacterium tuberculosis IgG antibody(IgG antibody)detection,tuberculosis infection T lymphocyte spot test(T-SPOT)and sputum Mycobacterium tuberculosis nucleic acid PCR detection(TB-DNA)in the diagnosis of osteoarticular tuberculosis.Methods A retrospective analysis of 196 cases of osteoarticular tuberculosis diagnosed in our department from January 2017 to October 2018 was performed.In addition,non-tuberculous patients of the same period were selected as the control group,a total of 69 cases.All patients used three detection techniques:serum tuberculosis IgG antibody,peripheral blood T-SPOT and sputum TB-DNA.Compare the sensitivity and specificity of the three detection techniques and evaluate the clinical value.Results Among the 196 cases of osteoarticular tuberculosis,the sensitivity of the three detection techniques:T-SPOT>TB IgG antibody>sputum TB-DNA,the difference was statistically significant(P<0.05);Among 69 non-tuberculosis patients,the three detection techniques specific sputum TB-DNA>TB IgG antibody>T-SPOT,the difference was statistically significant(P<0.05).Conclusion There are differences in the sensitivity and specificity of the three detection technologies.T-SPOT has the highest sensitivity and sputum TB-DNA has the highest specificity.The rapid diagnosis of osteoarticular tuberculosis requires a combination of multiple detection technologies.