结核感染T细胞斑点试验及A、B两种抗原检测在活动性结核病诊断中的意义  

Significance of T-SPOT.TB test and two antigens A and B detection in diagnosis of active tuberculosis

作　　者：时翠林[1] 徐俊驰[1] 汤在详 陈兴年[1] 曹俊[1] 冯彦军[1] 郭健[1] 吴妹英[1] 叶志坚[1] SHI Cuilin;XU Junchi;TANG Zaixiang(Department of Infectious Diseases,Fifth.People's Hospital of Suzhou ,Suzhou 215007,CHINA)

机构地区：[1]苏州市第五人民医院(苏州市传染病医院)感染病科,江苏215007 [2]苏州大学医学部公共卫生学院流行病与卫生统计学系

出　　处：《江苏医药》2018年第12期1419-1422,共4页Jiangsu Medical Journal

基　　金：苏州市临床重点病种诊疗技术专项项目(LCZX201514);苏州市中西医结合科研基金(SYSD2016167)

摘　　要：目的探讨结核感染T细胞斑点试验(T-SPOT.TB)及A、B两种抗原检测在活动性结核病诊断中的意义。方法将107例活动性结核病患者的T-SPOT.TB结果与最终临床诊断进行比较,评价其诊断灵敏度、特异度、阳性预测值和阴性预测值,并对T-SPOT.TB阳性斑点分布特点进行分析。结果 T-SPOT.TB诊断活动性结核病的灵敏度为86.0%(92/107),特异度为90.7%(88/97),阳性预测值91.1%(92/101),阴性预测值85.4%(88/103)。T-SPOT.TB两种抗原A和B的检测结果阳性率无统计学差异;阳性斑点分布特征分析显示,抗原A在低阳性斑点区呈现活动性结核病检出高峰,而抗原B则分别在高、低阳性斑点区呈现活动性结核病检出高峰,进一步分析抗原B在高阳性斑点区100～125的检出者均为肺外结核患者。结论 T-SPOT.TB对活动性结核病的诊断具有较好的临床应用价值,A、B两种抗原表现出不同的阳性检出规律和意义。Objective To investigate the significance of tuberculous infection of T cells spot test (T-SPOT.TB test)and two antigens A and B detection in the diagnosis of active tuberculosis. Methods The sensitivity,specificity,positive predictive value and negative predictive value of T-SPOT.TB test from 107 patients with active tuberculosis were analyzed according to the final clinical diagnosis.The distribution characteristics of T-SPOT.TB test positive spots were analyzed.Results The sensitivity,specificity,positive predictive value,negative predictive value of T-SPOT.TB test were 86.0%(92/107),90.7%(88/97),91.1%(92/101) and 85.4%(88/103),respectively.There was no significant difference in the positive rate of tuberculosis diagnosis between two antigens of A and B.Positive spots distribution analysis showed that antigen A presented active tuberculosis peak detection in low positive spots range,while antigen B presented active tuberculosis peak detection both in low and high positive spots range,and the patients with high positive spots of antigen B range of 100-125 were all with extrapulmonary tuberculosis.Conclusion T-SPOT.TB test is favorable for the current diagnosis of tuberculosis as auxiliary diagnostic methods.The two antigens A and B show different patterns and significance of positive detection.

关 键 词：结核病 结核感染T细胞斑点试验 

分 类 号：R52[医药卫生—内科学]