外周血结核T细胞检测在肺结核涂阴患者中的临床研究  

Clinical study of tuberculosis infected T cells in smear negative patients with pulmonary tuberculosis

作　　者：黄其俊[1] 宋大伟[1] 吴坚敏[1] 汪强[2] 

机构地区：[1]浙江省余姚市人民医院检验科,浙江余姚315400 [2]浙江中医药大学附属第二医院检验科,浙江杭州310005

出　　处：《中国现代医生》2015年第28期99-102,共4页China Modern Doctor

基　　金：浙江省教育厅科研项目(Y201328999);浙江省余姚市人民医院院级课题(YJY18A)

摘　　要：目的探讨外周血结核T细胞检测在肺结核涂阴患者诊断中的临床价值。方法将研究对象分为两组:肺结核组96例,其中涂阴肺结核71例,其他肺部疾病组60例。所有患者分别进行外周血结核T细胞的γ-干扰素释放试验(TB-IGRA)、血清结核抗体和结核菌素试验(PPD试验)。结果 TB-IGRA试验、结核抗体和PPD试验在涂阴肺结核组与其他肺部疾病组阳性率比较,差异有统计学意义(P均<0.01);TB-IGRA试验在肺结核涂阴组与涂阳组中定性与定量结果比较,差异无统计学意义(P均>0.05),其在涂阴肺结核诊断中敏感性和特异性分别是90.1%和91.7%,阳性预测值、阴性预测值分别是92.8%和88.7%,与结核抗体和PPD试验比较,差异有统计学意义(P<0.01)。结论外周血结核T细胞检测在涂阴肺结核的诊断上具有敏感性和特异性高、结果客观等优点,有助于对涂阴肺结核的患者进行鉴别诊断,以避免误诊误治。Objective To investigate the clinical value of detection of peripheral blood T cells in diagnosis of smear negative pulmonary tuberculosis. Methods The study subjects were divided into two groups： 96 cases of pulmonary tu- berculosis,71 cases of smear negative pulmonary tuberculosis, 60 eases of other pulmonary diseases. All patients were treated with peripheral blood tuberculosis T cell interferon gamma release test（TB-IGRA）, serum tuberculosis antibody and skin tuberculin test （PPD）. Results Comparison of TB-IGRA test, tuberculosis antibody and PPD test in smear negative pulmonary tuberculosis patients with other pulmonary diseases group positive rate P all 〈0.01; TB-IGRA test in the smear negative group and smear positive group qualitative and quantitative resuhs（P〉0.05）, the sensitivity and specificity of TB-IGRA in the diagnosis of smear negative pulmonary tuberculosis were 90.1% and 91.7%. The positive predictive value and the negative predictive value were 92.8% and 88.7% respectively. Compared with tuberculosis an- tibody and PPD test（P〈0.01 ）. Conclusion The detection of T cells in peripheral blood has the advantages of sensitivity, specificity and objective in the diagnosis of smear negative tuberculosis. It is helpful for the differential diagnosis of scnear negative tuberculosis patients in order to avoid misdiagnosis and mistake.

关 键 词：痰涂片 肺结核 诊断 外周血结核感染T细胞 

分 类 号：R521[医药卫生—内科学]