γ-干扰素释放试验(T-SPOT.TB)及结核蛋白芯片检测对结核病诊断价值的对比分析  

To analysis the value of interferon-gamma release assay( T-SPOT. TB)and tuberculosis protein chip for diagnosis tuberculosis

作　　者：李玉静[1] 孙志平[1] 张彦坤[1] 邢志伟[1] 张珣[1] 翟倩[1] 李曼[1] 王亮[1] LI Yu - jing SUN Zhi - ping ZHANG Yan- kun XING Zhi -wei ZHANG Xun ZHAI Qian LI Man WANG Liang(The Chest Hospital of Hebei Province, Shijiazhuang 050041, China)

机构地区：[1]河北省胸科医院,石家庄050041

出　　处：《医学动物防制》2016年第10期1063-1066,共4页Journal of Medical Pest Control

基　　金：2013年河北省科学技术研究与发展指导计划项目(132777269)

摘　　要：目的分析γ-干扰素释放试验（T-SPOT.TB）及结核蛋白芯片检测结核病的敏感性及特异性,探讨其对结核病的诊断价值。方法选取结核病病例398例为结核病组,其中肺结核组310例,肺外结核组88例;非结核病病例149例作为对照组。肺结核组中另分为抗酸染色涂片阴性肺结核组（涂阴组）191例,抗酸染色涂片阳性肺结核组（涂阳组）119例,均进行T-SPOT.TB及结核蛋白芯片试验的检测。结果结核病组T-SPOT.TB敏感性为83.6%（333/398）,结核蛋白芯片敏感性为69.9%（278/398）,两种方法差异有统计学意义（χ2=21.302,P〈0.05）。肺结核组TSPOT.TB敏感性为81.6%（253/310）,结核蛋白芯片敏感性为67.7%（210/310）,两种方法差异有统计学意义（χ2=15.771,P〈0.05）。涂阴组T-SPOT.TB敏感性为81.7%（156/191）,结核蛋白芯片敏感性为60.7%（116/191）,两种方法差异有统计学意义（χ2=20.428,P〈0.05）;涂阳组T-SPOT.TB敏感性为81.5%（97/119）,结核蛋白芯片敏感性为79.0%（94/119）,两种方法差异无统计学意义（χ2=0.239,P〉0.05）。肺外结核组T-SPOT.TB敏感性为90.9%（80/88）,结核蛋白芯片敏感性为77.3%（68/88）,两种方法差异有统计学意义（χ2=6.116,P〈0.05）。结论T-SPOT.TB方法对结核病诊断的敏感性高于结核蛋白芯片法,对涂片阴性肺结核以及肺外结核病的诊断有很好的价值。Objective To analysis sensibility and specificity of T - SPOT. TB and tuberculosis protein chip test for tuberculosis. To evaluate their value for diagnosis tuberculosis. Methods There are 398 tuberculosis patients, including 310 pulmonary tuberculosis patients and 88 extrapulmonary tuberculosis patients. There are 149 patients in the control group, those patients not diagnosed tuberculosis. The patients in the tuberculosis group were divide into two groups. 191 tuberculosis patients（ smear - nega- tive pulmonary tuberculosis） and 119 tuberculosis patients （smear- positive pulmonary tuberculosis）. All of the patients accepted test of T - SPOT. TB and tuberculosis protein chip. Results The sensibility of T - SPOT. TB and tuberculosis protein chip in the group of tuberculosis was 83.6% and 69. 9%, there was significant difference between the two methods（ P 〈 0. 05 ）. The sensi- bility of T - SPOT. TB and tuberculosis protein chip in the group of pulmonary tuberculosis was 81.6% and 67.7%, there was significant difference between the two methods （ P 〈 0.05 ）. The sensibility of T - SPOT. TB and tuberculosis protein chip was 81.7% and 60. 7% in the group of smear - negative pulmonary tuberculosis. There was significant difference between the two methods （ P 〈 0.05 ）. The sensibility of T - SPOT. TB and tuberculosis protein chip was 81.5 % and 79. 1% in the group of smear -positive pulmonary tuberculosis. Two methods was no significant difference（ P 〉 0.05 ）. In the group of extrapulmonary tubercu- losis that the sensibility of T - SPOT. TB and tuberculosis protein chip was 90.9% and 77. 3%, two methods was significant difference （P 〈 0. 05 ）. Conclusion The sensibility of T - SPOT. TB was higher than tuberculosis protein chip for diagnosis tu- berculosis, this method was meaningful for smear - negative pulmonary tuberculosis and extrapulmonary tuberculosis.

关 键 词：肺外结核 涂阴肺结核 T-SPOT.TB 

分 类 号：R446.9[医药卫生—诊断学] R52[医药卫生—临床医学]