结核感染酶联免疫技术在白血病合并活动性结核病感染诊断中的应用  

Application of enzyme linked immunosorbent assay in diagnosis of leukemia complicated with active tuberculosis infection

作　　者：王欣俞 杨艳辉 孙斌 刘淑娟 高德禄 

机构地区：[1]河北燕达医院检验科,河北廊坊066251 [2]中国人民解放军第三〇九医院检验科,北京100091 [3]黑龙江省大庆市第二医院检验科,163461

出　　处：《检验医学与临床》2017年第A02期29-32,共4页Laboratory Medicine and Clinic

基　　金：河北省廊坊市科技局项目（2015013059）.

摘　　要：目的 探讨结核感染酶联免疫技术（T-SPOT.TB）在白血病合并活动性结核病感染诊断中的应用.方法 选取并分析河北燕达医院血液科342例白血病患者进行 T-SPOT.TB测定,将 T-SPOT.TB检测结果与最终临床诊断进行比较,以敏感性、特异性、阳性预测值、阴性预测值为评价指标.结果 11例患者最终诊断为活动性结核病,其中3例细菌学确诊的活动性结核病患者中3例T-SPOT.TB结果阳性,敏感性为100%,特异性为100%;8例诊断肺外结核病组的患者中6例 T-SPOT.TB结果阳性,敏感性为75%,特异性为25%;在331例排除活动性结核病诊断的患者中,328例患者 T-SPOT.TB检测结果为阴性,3例为阳性,其敏感性为0.91%,特异性为99.1%.T-SPOT.TB测定在该项研究中阳性预测值为75%,阴性预测值为99.4%,三组比较无显著性差异（P=0.581）.结论 白血病患者作为免疫缺陷的特殊人群,活动性结核病发病率明显较正常人群高,发病后临床特征不典型,病原学依据难以获取给诊断带来困难,本研究显示较高的T-SPOT.TB阴性预测值提示阴性结果有助于排除白血病合并活动性结核病的诊断,可更好地辅助临床医生进行诊断,有助于提高结核病的发现率和治愈率,提升对结核病的综合防控能力.Objective To investigate the applicationof enzymelinked immunosorbent assay for tuberculosis infection（T-SPOT. TB）in the diagnosis of leukemia complicated with active tuberculosis.Methods Selected 342 cases of leukemia patients from hema-tology department of Hebei Yanda hospital and determined by T-SPOT.TB,T-SPOT.TB test results and the final clinical diagno-sis compared with the sensitivity,specificity,positive predictive value and the negative predictive value as the evaluation index.Re-sults 11 cases of patients with a final diagnosis of active tuberculosis,including 3 cases of bacteriologically confirmed tuberculosis in 3 cases of T-SPOT.TB were positive,the sensitivity was 100%,specificity was 100%;8 cases were diagnosed extrapulmonary tuberculosis patients in 6 cases of T-SPOT.TB were positive,the sensitivity was 75%,specificity was 25% in 331 patients;cases of active tuberculosis in 328 cases of T-SPOT.TB were detected,3 cases were positive,the sensitivity was 0.91%,specificity was 99. 1%.The positive predictive value of T-SPOT.TB in this study was 75%,and the negative predictive value was,and there was no significant difference between the three groups（P=0.581）.Conclusion Patients with leukemia as a special population immunodefi-ciency,active tuberculosis incidence rate was obviously higher than the normal population,after the onset of atypical clinical fea-tures,pathological evidence is difficult to obtain to diagnosis difficult,this study shows that the prediction of higher T-SPOT.TB values of negative diagnosis revealed negative results helps to eliminate leukemia complicated with active tuberculosis complicated with active tuberculosis infection,diagnosis and differential diagnosis has a unique advantage in leukemia.

关 键 词：结核感染酶免疫技术 白血病合并活动性结核病 特异性 敏感性 

分 类 号：R52[医药卫生—内科学]