结核感染T细胞斑点试验对艾滋病合并肺结核的临床诊断价值  

Clinical value of T-cell enzyme-linked immunospot test in diagnosis of AIDS complicated with tuberculosis

作　　者：童学成[1] 陈国春[1] 濮翔科[1] 徐天敏[1] 

机构地区：[1]常州市第三人民医院感染科,江苏常川213001

出　　处：《中华医院感染学杂志》2014年第14期3632-3634,共3页Chinese Journal of Nosocomiology

基　　金：江苏省预防医学科研基金资助项目(Y2012072)

摘　　要：目的评价结核感染T细胞斑点试验(T-SPOT.TB)诊断艾滋病合并肺结核的临床应用价值,以利于疾病诊断与鉴别诊断。方法选取45例合并肺结核的艾滋病患者(研究组)及30例未感染肺结核的艾滋病患者(对照组)行T-SPOT.TB检测,并同时行结核菌素纯蛋白衍生物(PPD)试验。结果研究组T-SPOT.TB阳性率为80.0%,显著高于对照组13.3%(χ2=32.14,P<0.01),PPD试验在两组间的阳性率分别为13.3%和6.7%;研究组CD4+T细胞计数≥200/μl及<200/μl的患者中T-SPOT.TB检测阳性率分别为86.7%和76.7%,差异无统计学意义;T-SPOT.TB检测艾滋病合并肺结核的敏感性为80.0%、特异性为76.7%,阳性似然比6.0,阴性似然比0.1;在PPD试验中分别为13.3%、93.3%、2.0、0.9。结论 T-SPOT.TB对艾滋病合并肺结核具有较高的诊断效能。OBJECTIVE To evaluate the clinical value of T cell enzyme-linked immunospot（T-SPOT.TB）in diagnosis of patients with acquired immunodeficiency syndrome（AIDS）complicated by tuberculosis.METHODS Totally 45AIDS patients complicated with tuberculosis were assigned as the observation group,and 30AIDS patients without tuberculosis were set as the control group,then the T-SPOT.TB test was carried out,meanwhile,the tuberculin purified protein derivative（PPD）test was performed.RESULTS The positive rate of T-SPOT.TB was 80.0% in the observation group,significantly higher than 13.3% in the control group（χ2=32.14,P〈0.01）;the positive rate of PPD test was 13.3%in the observation group,6.7%in the control group.The positive rate of T-SPOT.TB test was 86.7%in the patients with CD4＋T counts no less than 200/μl in the observation group,76.7%in the patients with CD4＋T counts less than 200/μl,and there was no statistically significant difference.The sensitivity of the T-SPOT.TB test in diagnosis of AIDS complicated with tuberculosis was 80.0%,the PPD test 13.3%;the specificity of the T-SPOT.TB test was 76.7%,the PPD test 93.3%;the positive likelihood ratio of the T-SPOT.TB test was 6.02,the PPD test 1.99;the negative likelihood ratio of the T-SPOT.TB test was 0.01,the PPD test 0.93.CONCLUSIONS The T-SPOT.TB test has higher efficiency in diagnosis of AIDS complicated with tuberculosis.

关 键 词：结核感染 T细胞斑点试验 结核菌素纯蛋白衍生物试验 艾滋病 肺结核 

分 类 号：R446[医药卫生—诊断学]