感染T细胞斑点试验在耐多药肺结核诊断中的应用价值  

Application value of T-SPOT.TB test in the diagnosis of multi-drug resistant tuberculosis

作　　者：胡钰卿[1] 潘爱珍[2] 王静[1] 朱敏[1] 

机构地区：[1]杭州市红十字会医院结核实验室,浙江杭州310003 [2]浙江省疾病预防控制中心结核病预防控制所结核实验室,浙江杭州310051

出　　处：《中国现代医生》2016年第25期70-73,共4页China Modern Doctor

基　　金：浙江省医药卫生适宜技术成果转化计划(B类)(2015ZHB001)

摘　　要：目的分析探讨感染T细胞斑点试验（T—SPOT．TB）在耐多药肺结核诊断中的应用价值。方法选择2014年1月～2016年1月我院收治的耐多药肺结核患者71例，另选择35例同期健康体检者作为对照组，比较各种检测方法诊断的阳性率，并采用敏感性、特异性、准确度作为诊断试验的评价指标。结果T—SPOT．TB检测诊断耐多药肺结核阳性率最高，达95．8％，显著高于其他各项检测方法，差异具有统计学意义（P〈0．05）。抗酸杆菌涂片、结核菌培养、T—SPOT．TB检测用于诊断耐多药肺结核的敏感性较高，达90％以上。T—SPOT．TB检测用于诊断耐多药肺结核的特异性最高，达91．9％，显著高于其他各项检测方法，差异具有统计学意义（P〈0．05）。T—SPOT．TB检测用于诊断耐多药肺结核的准确度最高，达96．2％，显著高于其他各项检测方法，差异具有统计学意义（P〈0．05）。结论与其他检查方法相比，感染T细胞斑点试验对诊断耐多药肺结核具有特异性高、准确度高的优点，值得广泛推广和应用。Objective To analyze the application value of T-SPOT.TB test in the diagnosis of multi-drug resistant tuberculosis. Methods A total of 71 patients with multi-drug resistant tuberculosis who were admitted to our hospital from January 2014 to January 2016 were selected. Another 35 healthy subjects were selected as the control group. The diagnosis positive rate of each test method was compared, and sensitivity, specificity and accuracy were applied as the evaluation indicators of the diagnostic test. Results The positive rate of T-SPOT.TB test in the diagnosis of multi-drug resistant tuberculosis was the highest, reaching up to 95.8%, significantly higher than that of other test methods, and the differences were statistically significant （P〈0.05）. The sensitivity of acid-fast bacillus test, tuberculous bacillus culture and T-SPOT.TB test in the diagnosis of multi-drug resistant tuberculosis was higher, reaching over 90%. The specificity of T-SPOT.TB test in the diagnosis of multi-drug resistant tuberculosis was the highest, reaching up to 91.9%, significantly higher than that of other test methods, and the differences were statistically significant（P〈0.05）. The accuracy of T-SPOT.TB test in the diagnosis of multi-drug resistant tuberculosis was the highest, reaching up to 96.2%, significantly higher than that of other test methods, and the differences were statistically significant（P〈0.05）. Conclusion Compared with other test methods, T-SPOT.TB test in the diagnosis of multi-drug resistant tuberculosis has advantages of high specificity and high accuracy, which is worthy of wide promotion and application.

关 键 词：耐多药肺结核 感染T细胞斑点试验 敏感性 特异性 

分 类 号：R521[医药卫生—内科学]