摘要
目的探讨T细胞斑点试验(T-SPOT.TB)在诊断HIV/AIDS合并肺结核患者中的临床应用价值。方法选择2015年3月至2018年10月本院收治的HIV/AIDS疑似肺结核患者148例为研究对象,其中诊断结核组52例,非结核组96例,对两组患者进行T-SPOT.TB、PPD、痰菌检测(涂片/培养),探索T-SPOT.TB在HIV/AIDS合并肺结核检测的敏感性、特异度以及不同CD4^+T淋巴细胞水平(≥200 Cells/μL、<200 Cells/μL)情形,对T-SPOT.TB检测阳性率的影响。结果结核组患者T-SPOT.TB阳性率为78.85%,非结核组患者阳性率仅13.54%,两组差异有统计学意义(χ^2=62.07,P<0.01);T-SPOT.TB的敏感度为78.85%,PPD检测敏感度为17.31%,差异有统计学意义(χ^2=39.44,P<0.01)。HIV/AIDS合并肺结核患者中,TSPOT.TB阳性率(78.85%)与痰菌检测阳性率(25.00%)比较差异有统计学意义(χ^2=30.20,P<0.01);不同CD4^+水平对T-SPOT.TB检测阳性率,差异无统计学意义。结论T细胞斑点试验是诊断HIV/AIDS合并肺结核的一种较快速敏感方法,可用于HIV/AIDS合并肺结核的辅助诊断。
Objective To explore the clinical value of T-SPOT.TB in the diagnosis of HIV/AIDS patients with pulmonary tuberculosis.Methods 52 suspected tuberculosis patients with HIV/AIDS and 96 non-tuberculosis patients in our hospital from March 2015 to October 2018 were selected as the research subjects.T-SPOT.TB,PPD and sputum bacteria(smear/culture)were detected in the two groups.The sensitivity and specificity of TSPOT.TB in the detection of HIV/AIDS combined with tuberculosis,as well as different CD4^+T lymphocyte levels(≥200 Cells/μL,<200 Cells/μL)and the influence of positive rate for T-SPOT.TB were explored.Results The positive rate of T-SPOT.TB was 78.85%in tuberculosis group and 13.54%in non-tuberculosis group.There was significant difference between the two groups(χ^2=62.07,P<0.01).The sensitivity of T-SPOT.TB was 78.85%,and the sensitivity of PPD was 17.31%.The difference was significant(χ^2=39.44,P<0.01).In HIV/AIDS patients with pulmonary tuberculosis,the positive rate of T-SPOT.TB(78.85%)was significantly higher than that of sputum bacteria(25.00%)(χ^2=30.20,P<0.01).Different levels of CD4^+had no significant effect on the positive rate of T-SPOT.TB.Conclusion T-cell spot test is a rapid and sensitive method for the diagnosis of HIV/AIDS complicated with tuberculosis,and it can be used as an assistant diagnostic tool for HIV/AIDS complicated with tuberculosis.
作者
柯昌明
龚云河
王珂
Ke Changming;Gong Yunhe;Wang Ke(Zunyi Honghuagang District People's Hospital,Zunyi,Guizhou,563000,China)
出处
《当代医学》
2020年第2期33-35,共3页
Contemporary Medicine
