结核感染T细胞斑点试验在辅助诊断骨结核中的应用价值  

Application value of T-cell spot test for tuberculosis infection in auxiliary diagnosis of skeletal tuberculosis

作　　者：吴青[1] 吕幸[1] 李艳[1] 徐万洲[1] 龚卫杰 吴泽刚[1] 蔡璇[1] 

机构地区：[1]武汉大学人民医院检验科,武汉市430060

出　　处：《广西医学》2016年第12期1649-1650,1657,共3页Guangxi Medical Journal

基　　金：国家临床重点专科建设项目(财社2010305)

摘　　要：目的探讨结核感染T细胞斑点试验(T-SPOT.TB)在辅助骨结核诊断中的应用价值。方法回顾性分析137例疑似骨结核患者的临床资料,根据临床表现、影像学检查、组织病理学检查、病原学检查结果以及临床抗结核治疗效果进行诊断,确认或临床诊断骨结核患者69例,非骨结核患者68例。所有患者治疗前均行结核菌素纯蛋白衍生物(TB-PPD)试验及T-SPOT.TB,分析T-SPOT.TB在辅助诊断骨结核中的效能。结果 T-SPOT.TB辅助诊断骨结核的敏感度、特异度、阳性预测值、阴性预测值分别为98.5%、91.2%、91.9%、98.4%,均高于TB-PPD试验辅助诊断骨结核的敏感度、特异度、阳性预测值、阴性预测值的50.7%、77.9%、70.0%、60.9%,差异有统计学意义(P<0.05)。结论 T-SPOT.TB可辅助诊断骨结核,其具有较高的诊断敏感性、特异性。Objective To explore the application value of T-cell spot test for tuberculosis infection（ T-SPOT. TB） in the auxiliary diagnosis of skeletal tuberculosis. Methods Clinical data of 137 patients suspected as skeletal tuberculosis were retrospectively analyzed. The patients were diagnosed according to clinical manifestation, the results of imaging examination, histopathological test and pathogen test, and clinical efficacy of antituberculosis. Of 137 patients, 69 were definitely or clinically diagnosed as skeletal tuberculosis, and 68 as non-skeletal tuberculosis. All patients received both purified protein derivative of tuberculin （ TB-PPD ） test and T-SPOT. TB before treatment. The efficacy of T-SPOT. TB for auxiliary diagnosis of skeletal tuberculosis was analyzed. Results The sensitivity, specificity, positive predictive value, and negative predictive value of T-SPOT. TB for auxiliary diagnosis of skeletal tuberculosis were higher than those of TB-PPD test,respectively（98.5% vs. 50.7% ,91.2% vs. 77.9% , 91.9% vs. 70.0%, and 98.4% vs. 60.9%, all P 〈 0.05 ）. Conclusion T-SPOT. TB can be applied to the auxiliary diagnosis of skeletal tuberculosis for its high diagnostic sensitivity and specificity.

关 键 词：骨结核 结核感染T细胞斑点试验 结核菌素纯蛋白衍生物试验 辅助诊断 

分 类 号：R529.21[医药卫生—内科学]