结核感染T细胞检测技术的临床应用研究  

Clinical application of tuberculosis infection T cell detection

作　　者：张立[1] 孙海柏[1] 侯志丽[1] 刘佳庆[1] 曹宏[1] 杜岩青[1] 周洪经[1] 

机构地区：[1]天津市海河医院检验科,天津300350

出　　处：《中华医院感染学杂志》2014年第22期5465-5466,5476,共3页Chinese Journal of Nosocomiology

基　　金：天津市卫生局科技基金资助项目(2012KR08)

摘　　要：目的探讨结核感染T细胞检测(T-SPOT.TB)在快速诊断结核菌感染中的应用。方法通过对2011年4月-2012年11月医院861例住院及门诊患者T-SPOT.TB的检测结果进行综合性分析,评估T-SPOT.TB作为常规筛选检查,诊断结核病的意义和应用。结果 292例肺结核患者T-SPOT.TB阳性,阳性率为91.10%、斑点数为275±102,其中125例活动期肺结核阳性率达到100.00%、斑点数为301±222;167例结核初期阳性率为84.43%、斑点数为110±35;117例肺外结核阳性率为81.20%、斑点数为201±87;45例结核性脑膜炎阳性率为88.89%、斑点数为182±110;67例结核性胸膜炎阳性率为74.63%、斑点数为172±101;5例结核合并HIV阳性率为100.00%、斑点数46±23;452例筛查中痰涂片的敏感性为94.06%、特异性为69.76%、阳性预测值为52.35%、阴性预测值为97.08%,痰培养的敏感性为100.00%、特异性为82.19%、阳性预测值为75.47%、阴性预测值为100.00%;T-SPOT.TB的敏感性为83.61%、特异性为96.15%、阳性预测值为96.23%、阴性预测值为83.33%。结论 T-SPOT.TB快速鉴定肺内以及肺外结核菌感染,可以提高结核病的诊断,达到早发现、早治疗以及斑点数的分析在治疗过程中可以协助临床医师诊治。OBJECTIVE To explore the clinical application of tuberculosis infection T cell detection （T‐SPOT .TB） in rapid diagnosis of Mycobacterium tuberculosis infection .METHODS From Apr 2011 to Nov 2012 ,the results of the T‐SPOT .TB detection of 861 hospitalized patients and outpatients were comprehensively analyzed ,and the significance of the T‐SPOT .TB that was used for the conventional screening examination was evaluated .RESULTS The T‐SPOT .TB was positive in 292 tuberculosis patients with the positive rate of 91 .10% ,the number of spots was 275 ± 102 ,the positive rate of 125 cases of active pulmonary tuberculosis reached 100 .00% ,the number of spots for the positive cases was 301 ± 222 ,and the positive rate of the 167 primary tuberculosis patients was 84 .43% .The number of spots was 110 ± 35 .The positive rate of the 117 pulmonary tuberculosis patients was 81 .20% ,the number of spots was 201 ± 87 , the positive rate of the 45 tuberculous meningitis patients was 88 .89% ,the number of spots was 182 ± 110 , the positive rate of the 67 cases of tuberculous pleurisy was 74 .63% ,the number of spots was 172 ± 101 .The positive rate of the 5 tuberculosis patients complicated with HIV was 100 .00% ,the number of spots was 46 ± 23 ,the sensitivity of the sputum smear was 94 .06% for the screening of 452 patients ,the specificity was 69 .76% ,the positive predictive value was 52 .35% ,the negative predictive value was 97 .08% ,the sensitivity of the sputum culture was 100 .00% ,the specificity was 82 .19% , the positive predictive value was 75 .47% ,the negative predictive value was 100 .00% ,the sensitivity of the T‐SPOT .TB was 83 .61% ,the specificity was 96 .15% ,the positive predictive value was 96 .23% ,the negative pre‐dictive value was 83 .33% .CONCLUSION The T‐SPOT .TB ,which can be used for the rapid identification of pul‐monary and extra pulmonary TB infection ,can improve the diagnosis of tuberculosis so as to achieve the early di‐agnosis and early treatment ,and the analysis

关 键 词：结核感染 T细胞检测 结核病 诊断 

分 类 号：R521[医药卫生—内科学]