结核菌感染T细胞斑点试验联合基因芯片检测在肺结核诊断中的效能

Efficacy of tuberculosis infection T cell spot test combined with gene chip detection in diagnosis of pulmonary tuberculosis

目的:观察结核菌感染T细胞斑点试验(T-SPOT.TB)联合基因芯片检测在肺结核诊断中的效能。方法:选取150例年龄>60岁疑似肺结核的患者作为研究对象,均行T-SPOT.TB、基因芯片检查。以痰培养及痰涂片检测结果为金标准,统计T-SPOT.TB、基因芯片单项及联合检测诊断肺结核的效能。结果:痰培养及痰涂片检出82例阳性,68例阴性;T-SPOT.TB检出80例阳性,70例阴性;基因芯片检出81例阳性,69例阴性;联合检测检出94例阳性,56例阴性;联合检测诊断肺结核的灵敏度、阴性预测值均高于T-SPOT.TB与基因芯片单项检测,漏诊率低于T-SPOT.TB与基因芯片单项检测;准确度高于T-SPOT.TB单项检测,差异均有统计学意义(P<0.05);T-SPOT.TB、基因芯片单项及联合检测诊断肺结核的特异度、误诊率、阳性预测值比较,差异均无统计学意义(P>0.05);联合检测与基因芯片单项检测诊断肺结核的准确度比较,差异无统计学意义(P>0.05)。结论:T-SPOT.TB联合基因芯片检测诊断肺结核能提高灵敏度、阴性预测值,降低漏诊率,效能优于T-SPOT.TB或基因芯片单项检测。

Objective:To observe efficacy of tuberculosis infection T cell spot test(T-SPOT.TB)combined with gene chip detection in diagnosis of pulmonary tuberculosis.Methods:150 cases of suspected pulmonary tuberculosis patients aged>60 years old were selected as the research objects,and all of them underwent T-SPOT.TB and gene chip examination.Taking the results of sputum culture and sputum smear examinations as the gold standard,the results of single T-SPOT.TB and single gene chip detection as well as combined detection of pulmonary tuberculosis were statistically analyzed,and their efficacies were compared.Results:Sputum culture and sputum smears detected 82 positive cases and 68 negative cases;T-SPOT.TB detected 80 positive cases and 70 negative cases;gene chip detected 81 positive cases and 69 negative cases;and combined detection detected 94 positive cases and 56 negative cases.The sensitivity and the negative predictive value of combined detection for the diagnosis of pulmonary tuberculosis were higher than those of single T-SPOT.TB and single gene chip detection the missed diagnosis rate was lower than those of single T-SPOT.TB and single gene chip detection;the accuracy was higher than single T-SPOT.TB;and the differences were statistically significant(P<0.05).There were no statistically significant differences in the specificity,the misdiagnosis rate,and the positive predictive value single and combined detection of t-spot.tb and gene chip in the diagnosis of pulmonary tuberculosis(P>0.05).Further,there was no statistically significant difference in the accuracy between combined detection and single gene chip detection in the diagnosis of pulmonary tuberculosis(P<0.05).Conclusions:The sensitivity,the negative predictive value,the missed diagnosis rate,and the efficiency of T-SPOT.TB combined gene chip detection in the diagnosis of pulmonary tuberculosis are better than single T-SPOT.TB and single gene chip detection.