T细胞斑点试验在活动性结核病与潜伏性结核感染鉴别诊断中的价值  

Value of T cells spot test in differentiating active tuberculosis from latent tuberculosis

作　　者：施宇佳[1] 曹琦[1] 毛正道[1] 陈意[1] 殷小伟[1] 张倩[1] 

机构地区：[1]南京医科大学附属常州第二人民医院呼吸病科,江苏省213000

出　　处：《江苏医药》2015年第15期1798-1800,共3页Jiangsu Medical Journal

摘　　要：目的探讨结核分枝杆菌特异性效应T细胞斑点数鉴别活动性结核病与潜伏性结核感染的价值。方法采用T细胞斑点试验(T-SPOT.TB)检验76例活动性结核病和81例潜伏性结核感染患者全血样本,确定T-SPOT.TB阳性且抗结核治疗未超过2周的活动性结核患者64例和潜伏性结核感染患者68例,分析其对应的T-SPOT.TB结果。结果 T-SPOT.TB阳性活动性结核病组T细胞斑点数中位数大于T-SPOT.TB阳性潜伏性结核感染组(133vs.67)(P<0.01);但T细胞斑点数在上述两组中的分布有较大范围的重叠。通过受试者工作特征曲线分析,以T细胞斑点数47.5作为鉴别活动性结核病与潜伏性结核感染的最佳界值,其敏感度为73.4%,特异度为67.5%。结论 T细胞斑点数在活动性结核病者高于潜伏性结核感染者。虽然T细胞斑点数一定程度上反映了体内的结核分枝杆菌负荷,但并不能用于鉴别活动性结核病与潜伏性结核感染。Objective To investigate the value of T-cell spot-forming units （SFU） in differentiating active tuberculosis from latent tuberculosis. Methods T cells spot test（T-SPOT. TB） was performed in 76 patients with active tuberculosis and 81 patients with latent tuberculosis, by which 64 active tuberculosis cases（group A） with T-SPOT. rib positive and anti-tuberculosis therapy for less than 2 weeks and 68 cases（group B） with latent tuberculosis were obtained and the results of T-SPOT. TB were analyzed. Results The median of SFU was more in group A than that in group B （133 vs. 67）（P〈0. 01）. However, there was a large range of overlapping in SFU distribution between two groups. Receiver-operating characteristics（ROC） curve analysis revealed that, taking SFU 47.5 as the cutoff value for differentiating active tuberculosis from latent tuberculosis, the sensitivity and specificity were 73.4% and 67.5 %, respectively. Conclusion The SFU in the patients with active tuberculosis is more than that in those with latent tuberculosis, which can not be recommended as an indicator for differentiating active tuberculosis from latent tuberculosis although it reflects tuberculosis activity in a certain degree.

关 键 词：结核 T细胞斑点试验 

分 类 号：R521[医药卫生—内科学]