探讨T-SPOT.TB、CA125、TB-Ab在痰菌阴性肺结核诊断中的价值  

Value exploration of T-SPOT.TB, CA125 and TB-Ab in diagnosis of sputum bacteria-negative pulmonary tuberculosis

作　　者：杜岩青[1] 张立[1] 冯爽[1] 冯冉冉[1] 

机构地区：[1]天津市海河医院检验科,天津300350

出　　处：《中国现代医生》2014年第32期43-45,共3页China Modern Doctor

摘　　要：目的探讨T细胞斑点试验(T-SPOT.TB)技术、糖类抗原125(CA125)测定与血清结核抗体(TB-Ab)测定,三种方法单一或联合检测对痰菌阴性肺结核的诊断价值。方法受试者均为我院住院患者共155例,其中痰菌阴性患者64例,痰菌阳性患者55例,非结核性肺疾病患者36例,对上述三项指标进行检测。结果单一指标诊断肺结核T-SPOT.TB的灵敏度为87.3%、特异度为83.3%,AUC为0.850,CA125的灵敏度为80.0%、特异度为72.2%、AUC为0.837;TB-Ab灵敏度为63.6%、特异度为80.6%、AUC为0.790;T-SPOT.TB和TB-Ab联合诊断的灵敏度为94.5%,特异度为79.8%,AUC为0.988,T-SPOT.TB、TB-Ab、CA125三指标联合检测灵敏度为96.4%,特异度为44.4%,AUC为0.966。结论使用单一方法诊断痰菌阴性肺结核,T-SPOT.TB最有价值;联合检测时,T-SPOT.TB联合TB-Ab灵敏度较高,AUC最高,对痰菌阴性肺结核的诊断具有更大的临床应用价值。Objective To investigate the diagnosis value of single or joint application of T cell spot test （T-SPOT.TB） technique, carbohydrate antigen 125 （CA125） determination and serum tuberculosis antibody （TB-Ab） determination in the detection of sputum bacteria-negative pulmonary tuberculosis. Methods All the 155 subjects were inpatients of Haihe Hospital, of which 64 patients were sputum bacteria-negative, 55 patients were sputum bacteria-positive and 36 patients suffered from non-tuberculosis pulmonary diseases. The above three indicators were detected. Results Regarding to single indicator diagnosis of pulmonary tuberculosis, the sensitivity, specificity and AUC of T-SPOT.TB were 87.3%, 83.3% and 0.850, the sensitivity, specificity and AUC of CA125 were 80.0%, 72.2% and 0.837, and the sensitivity, specificity and AUC of TB-Ab were 63.6%, 80.6% and 0.790. The sensitivity, specificity and AUC of T-SPOT. TB and TB-Ab joint detection were 94.5%, 79.8% and 0.988, and the sensitivity, specificity and AUC of T-SPOT.TB, TB-Ab and CA125 joint detection were 96.4%, 44.4% and 0.966. Conclusion For single-method diagnosis of sputum bacteria-negative pulmonary tuberculosis, T-SPOT.TB has the highest value; For joint detection, T-SPOT.TB combined with TB-Ab has higher sensitivity and the highest AUC, which is of larger clinical application value in the diagnosis of sputum bacteria-negative pulmonary tuberculosis.

关 键 词：T-SPOT.TB TB-AB CA125 诊断价值 

分 类 号：R521[医药卫生—内科学]