摘要
目的探讨结核感染T细胞斑点试验(T-SPOT.TB)在肺结核和肺外结核诊断中的应用价值。方法选取2014年6月～2017年6月于上海交通大学附属第六人民医院南院住院治疗的疑诊为活动性肺结核和肺外结核的患者200例,进行外周血T-SPOT.TB、皮肤结核菌素试验(PPD)和萋-尼抗酸染色(AFB)的检测,并比较3种方法的诊断价值。结果 T-SPOT.TB、PPD和AFB试验诊断结核病的敏感性、特异性、阴性预测值及精准度比较,差异有统计学意义(P <0.05);T-SPOT.TB诊断肺结核的敏感性、特异性、阳性预测值、阴性预测值及精准度高于PPD和AFB(P <0.05);T-SPOT.TB诊断肺外结核的敏感性、阴性预测值及精准度均高于PPD和AFB(P <0.05),而PPD与AFB比较,差异无统计学意义(P> 0.05)。结论 T-SPOT.TB诊断肺结核和肺外结核具有较高敏感性和特异性,是快速诊断结核感染的有效手段,值得临床应用推广。
Objective To evaluate the value of T-SPOT.TB in diagnosis of tuberculosis and extrapulmonary tuberculosis.Methods From June 2014 to June 2017,200 patients suspected to be active tuberculosis and extrapulmonary tuberculosis who were hospitalized in the South Hospital of the Sixth People's Hospital Affiliated to Shanghai Jiaotong University were selected for the detection of peripheral blood T-SPOT.TB,skin tuberculin test(PPD)and addendum antacid fast staining(AFB),and the diagnostic values of the three methods were compared.Results The sensitivity,specificity,negative predictive value and accuracy of T-SPOT.TB,PPD and AFB tests in the diagnosis of tuberculosis were compared,and the differences were statistically significant(P<0.05).The sensitivity,specificity,positive predictive value,negative predictive value and accuracy of T-SPOT.TB diagnosis of tuberculosis were higher than those of PPD and AFB(P<0.05).T-SPOT.TB had higher sensitivity,negative predictive value and accuracy in the diagnosis of extrapulmonary tuberculosis than PPD and AFB(P<0.05),while the difference between PPD and AFB was not statistically significant(P>0.05).Conclusion T-SPOT.TB diagnosis of tuberculosis and extrapulmonary tuberculosis has a high sensitivity and specificity,and is an effective means of rapid diagnosis of tuberculosis infection,which is worthy of clinical application and promotion.
作者
宋瑞红
沈魏
鲁立文
SONG Ruihong;SHEN Wei;LU Liwen(Department of Respiratory Medicine,the South Hospital of the Sixth People′s Hospital Affiliated to Shanghai Jiaotong University,Shanghai 201499,China)
出处
《中国医药导报》
CAS
2019年第1期157-161,共5页
China Medical Herald
基金
上海市奉贤区科学技术委员会科学技术发展基金项目(20141309)
关键词
结核感染T细胞斑点试验
肺结核
肺外结核
T-SPOT.TB test
Pulmonary tuberculosis
Extrapulmonary tuberculosis
