结核感染T细胞斑点试验对鉴别克罗恩病和肠结核的临床价值  

Clinical value of T-SPOT.TB to the differential diagnosis of Crohn′s disease and intestinal tuberculosis

作　　者：刘浏[1] 梁志忠[1] 贾柳萍[1] 黄鹤[1] 邓绿[1] 王泽伟[1] 伦伟健[1] 

机构地区：[1]南方医科大学附属南海医院消化内科,广东佛山528200

出　　处：《中华实用诊断与治疗杂志》2014年第6期570-571,共2页Journal of Chinese Practical Diagnosis and Therapy

基　　金：佛山市医学类科技攻关项目(201208186)

摘　　要：目的探讨结核感染T细胞斑点试验(T-SPOT.TB)在克罗恩病(Crohns disease,CD)和肠结核(intestinal tuberculosis,ITB)鉴别诊断中的价值。方法采用T-SPOT.TB检测26例CD、22例ITB患者静脉血标本,统计分析T-SPOT.TB在CD和ITB中的阳性率及诊断ITB的敏感度、特异度、阳性预测值和阴性预测值,比较T-SPOT.TB与结核菌素纯蛋白衍生物试验(purified protein derivative of tuberculin,PPD)诊断ITB的准确度。结果 T-SPOT.TB诊断CD、ITB的阳性率分别为7.7%、77.3%,差异有统计学意义(P<0.05);T-SPOT.TB诊断ITB的敏感度、特异度、阳性预测值和阴性预测值分别为77.3%、92.3%、89.5%和82.8%,准确度(85.4%)高于PPD(63.3%)(P<0.05);与PPD联合诊断ITB的敏感度、特异度、阳性预测值和阴性预测值分别为86.4%、65.4%、67.9%和85.0%,其准确度为75.0%。结论 T-SPOT.TB有助于鉴别CD和ITB,与PPD检测联合诊断ITB的敏感度较高。Objective To explore the clinical value of T-SPOT. TB to the differential diagnosis of Crohn＇s disease （CD） and intestinal tuberculosis （ITB）. Methods The peripheral blood samples of 26 CD patients and 22 ITB patients were detected by T-SPOT. TB. The positive rate of T-SPOT. TB for CD and ITB, the sensitivity, specificity, positive predictive value and negative predictive value for ITB were analyzed, and the accuracies of T-SPOT. TB and purified protein derivative of tuberculin test （PPD） for ITB were compared. Results The positive rates of T-SPOT. TB for CD and ITB were 7. 7% and 77. 3%, showing a significant difference （P-〈 0. 05）. The sensitivity, specificity, positive predictive value and negative predictive value of T-SPOT. TB for ITB were 77.3%, 92.3%, 89.5% and 82.8%. The accuracy rate of T-SPOT. TB was 85. 4% for ITB, higher than that of PPD （63. 3%）. The sensitivity, specificity, positive predictive value and negative predictive value of the combination of T-SPOT. TB and PPD for ITB were 86.4%, 65.4%, 67. 9% and 85. 0%, and the accuracy was 75. 0%. Conclusions T-SPOT. TB is helpful for differential diagnosis of CD and ITB, and the combination of T-SPOT. TB and PPD increases the sensitivity for ITB.

关 键 词：克罗恩病 肠结核 T淋巴细胞 

分 类 号：R574[医药卫生—消化系统] R524[医药卫生—内科学]