T–SPOT.TB、PPD试验以及SAT–TB检测在涂阴肺结核中的应用

Application of T–SPOT.TB, PPD Test and SAT–TB in Smear Negative Pulmonary Tuberculosis

目的:研究结核感染T细胞斑点试验(T–SPOT.TB)、结核菌素(PPD)试验以及结核分枝杆菌RNA恒温扩增实时检测技术(SAT–TB)在涂阴肺结核的应用价值。方法:选取2017年4月至2018年4月本院收治的肺结核患者200例,其中确诊涂阴肺结核的患者127例,都采用T–SPOT.TB、PPD试验以及SAT–TB检测,比较各自灵敏度、特异度、准确率。结果:(1)T–SPOT.TB和PPD试验检测比较,T–SPOT.TB的特异度、灵敏度、准确率及阴性预测值均高于PPD试验,差异均具有统计学意义(P <0.05),而阳性预测值比较,差异无统计学意义(P> 0.05)。(2)T–SPOT.TB和SAT–TB检测比较,T–SPOT.TB的特异度、灵敏度、准确率、阴性预测值和阳性预测值均高于SAT–TB检测,差异均具有统计学意义(P <0.05)。(3)PPD试验和SAT–TB检测比较,PPD方法的特异度、准确率、阴性预测值均高于SAT–TB检测,差异均具有统计学意义(P <0.05),而灵敏度、阳性预测值比较,差异无统计学意义(P> 0.05)。结论:T–SPOT.TB相对于PPD试验及SAT–TB检测,在涂阴肺结核中诊断具有更高的价值。

Objective To study the value of t-cell SPOT test(spot.tb),tuberculin(PPD)test and mycobacterium tuberculosis RNA constant temperature amplifi cation real-time detection technology(SAT-TB)for negative tuberculosis.Methods 200 cases of pulmonary node patients admitted to Qingyuan chronic disease prevention hospital from April 2017 to April 2018 were selected,among which 127 cases of smear-negative pulmonary tuberculosis were diagnosed.T–SPOT.TB,PPD test and SAT-TB test were used to compare their sensitivity,specifi city and accuracy.Results(1)the specifi city,sensitivity,accuracy and negative predictive value of T–SPOT.TB were higher than that of PPD test,and the difference was statistically signifi cant(P<0.05),while the difference was not statistically signifi cant(P>0.05).(2)The specifi city,sensitivity,accuracy,negative predictive value and positive predictive value of T–SPOT.TB were higher than that of SAT-TB,and the differences were statistically signifi cant(P<0.05).(3)PPD test and SAT-TB test showed higher specificity,accuracy,negative predictive value than SAT-TB test,with statistically signifi cant differences(P<0.05),but no statistically significant differences in sensitivity and positive predictive value(P>0.05).Conclusion Compared with PPD test and SAT-TB test,T–SPOT.TB,the diagnosis of smear negative pulmonary tuberculosis has higher value.