摘要
目的探讨外周血结核感染T细胞斑点试验(T-SPOT.TB)在泌尿系结核诊断及鉴别诊断中的临床应用价值。方法收集2013年1月—2015年2月黑龙江省传染病防治院收治的拟诊为泌尿系结核患者132例,以综合临床资料分析诊断泌尿系结核患者101例为结核病实验组、非结核性泌尿系疾病患者31例为非结核病对照组。对两组患者分别进行外周血T-SPOT.TB、尿液结核分枝杆菌培养、尿液结核分枝杆菌聚合酶链反应(TB-PCR)、结核分枝杆菌耐药基因芯片技术、PPD试验及血清结核抗体(TB-Ab)检测。计算两组患者采用上述检测技术进行临床诊断的阳性率、敏感度、特异度、阳性预测值及阴性预测值,将实验组与对照组每种检测结果分别进行统计学检验,应用SPSS 19.0软件进行统计学分析,计数资料用率或构成比表示,组内及组间率的比较采用卡方检验,以P<0.05为差异有统计学意义。结果 T-SPOT.TB诊断泌尿系结核的敏感度为77.23%、特异度为70.97%,培养法敏感度为27.72%、特异度为100.00%,TB-PCR敏感度为31.68%、特异度为100%,基因芯片技术敏感度为20.79%、特异度为100%,PPD试验敏感度为82.18%、特异度为38.71%,TB-Ab敏感度为68.32%、特异度为54.84%,分析表明T-SPOT.TB检测对于泌尿系结核病的早期诊断具有更加明显的优势。结论外周血T-SPOT.TB检测技术对泌尿系结核的诊断及鉴别诊断具有较高的敏感度及特异度,值得临床推广。
Objective To explore the clinical value of T cell spot test （T-SPOT.TB） in the diagnosis and differential diagnosis of tuberculosis （TB） of the urinary system. Methods A total of 132 patients diagnosed as suspected TB of the urinary system in Heilongjiang Province Hospital for Infectious Disease Prevention and Treatment from January 2013 to February 2015 were selected as the research objects, and then 101 patients were diagnosed with TB of the urinary system by the comprehensive clinical datum analysis and they were chosen into a TB experiment group and other 31 cases were chosen into a control group （non-TB group）. The peripheral blood T-SPOT.TB, urine Mycobacterium tuberculosis culture, urine M. tuberculosis polymerase chain reaction （TB-PCR）, M. tuberculosis drug resistance gene chip technology, PPD test and serum tuberculosis antibody （TB-Ab） were detected in the patients of two groups. The positive rate, sensitivity, specificity, positive predictive value and negative predictive value of the two groups were calculated by the above detection techniques, and the data of each group were analyzed statistically by SPSS 19.0 software. Results The sensitivity and specificity of T-SPOT.TB in the diagnosis of TB of the urinary system were 77.23% and 70.97% respectively; the sensitivity and specificity of the culture method were 27.72% and 100.00% respectively; the sensitivity and specificity of TB-PCR were 31.68% and 100% respectively; the sensitivity and specificity of the gene chip technology were 20.79% and 100% respectively; the sensitivity and specificity of the PPD test were 82.18% and 38.71% respectively; the sensitivity and specificity of TB-Ab were 68.32% and 54.84% respectively, T-SPOT.TB test has more obvious advantages for early diagnosis of urinary tuberculosis. Conclusion The detection of T-SPOT.TB in peripheral blood has high sensitivity and specificity in the diagnosis and differential diagnosis of TB of the urinary system, and it is worth popularizing in the clinical practice.
作者
陈柳
齐凤荣
李晓南
尹鸿林
CHEN Liu;QI Fengrong;LI Xiaonan;YIN Honglin(Heilongjiang Provincial Institute of Infectious Diseases, Harbin, Heilongjiang 150000, China)
出处
《中国热带医学》
CAS
2018年第6期538-542,共5页
China Tropical Medicine
关键词
泌尿生殖系统结核
外周血结核感染T细胞斑点试验(T-SPOT.TB)
免疫学试验
敏感度
特异度
tuberculosis of genitourinary system
T cell spot test of Mycobacterium tuberculosis infection in peripheral blood （T-SPOT.TB）
immunological test
sensitivity
specificity
