结核感染T细胞斑点实验在结核病诊断中的价值  

The diagnostic value of T-SPOT.TB in tuberculosis

作　　者：徐茜 贺家勇 常炜 甫拉提.热西提 王松 

机构地区：[1]新疆医科大学基础医学院免疫学教研室,乌鲁木齐830011 [2]中国石油乌鲁木齐石油化工总厂职工医院外一科,乌鲁木齐830019 [3]新疆医科大学第一附属医院临床医学研究院,乌鲁木齐830054 [4]新疆维吾尔自治区胸科医院胸外中心,乌鲁木齐830049

出　　处：《新疆医科大学学报》2018年第3期308-310,314,共4页Journal of Xinjiang Medical University

基　　金：新疆重大疾病重点实验室开放课题(SKLB-XJMDR-2015Y8)

摘　　要：目的探讨结核菌感染T细胞斑点实验(T-SPOT.TB)在结核病中的诊断价值,比较研究T-SPOT.TB、结核分枝杆菌DNA测定(TB-DNA)和结核菌素试验(TST)检测在肺结核诊断中的作用。方法收集新疆维吾尔自治区胸科医院痰菌阴性肺结核60例(痰菌阴性组),另纳入痰菌阳性肺结核患者(34例)为痰菌阳性组,以及肺癌、慢性阻塞性肺疾病和支气管肺炎患者(35例)为非结核病组。采用T-SPOT.TB、TB-DNA和TST实验方法对痰菌进行检测。结果 3组T-SPOT.TB阳性率经比较差异有统计学意义(P<0.05)。肺结核组(包括痰菌阴性组、痰菌阳性组)的T-SPOT.TB阳性率均明显高于非结核病组(P<0.05)。痰菌阴性组和痰菌阳性组T-SPOT.TB阳性率差异无统计学意义(χ~2=1.207,P>0.05)。单一指标检测肺结核,T-SPOT.TB的敏感性和特异型分别为88.3%和94.3%,其敏感性高于TST和TB-DNA;其特异性低于TST,高于TB-DNA。结论T-SPOT.TB对痰菌阴性肺结核病的敏感性和特异性都有明显的优势,可以作为痰菌阴性和阳性肺结核病早期诊断的一种辅助检查手段,具有快速、准确的诊断价值。Objective To investigate the diagnostic value of T-SPOT.TB in tuberculosis,and study the role of T-SPOT.TB,TB-DNA and TST in the diagnosis of pulmonary tuberculosis.Methods Sixty patients(sputum negative group)with sputum negative tuberculosis were collected from the Department of Thoracic Medicine, Xinjiang Uygur Autonomous Region,and 35 patients with sputum positive tuberculosis were included in the sputum positive group.35 patients with lung cancer,chronic obstructive pulmonary disease or bronchial pneumonia were named non-tuberculosis group.T-SPOT.TB,TBDNA and TST were used to detect sputum tubercle bacillus.Results The positive rate of T-SPOT.TB in the three groups was statistically significant(P <0.05).The positive rate of T-SPOT.TB in tuberculosis group(including sputum negative group and sputum positive group)was higher than that in non-tuberculosis group(P <0.05).There was no significant difference in the positive rate of T-SPOT.TB between sputum negative group and sputum positive group(χ2=1.207,P >0.05).The sensitivity and specificity of T-SPOT.TB were 88.3%and 94.3%,respectively.The sensitivity was higher than that of TST and TBDNA,and the specificity was lower than that of TB-DNA.Conclusion T-SPOT.TB has obvious advantages in the sensitivity and specificity of tuberculosis.TB for sputum negative pulmonary tuberculosis have obvious advantages,which can be used as an auxiliary examination method for the early diagnosis of sputum negative and positive pulmonary tuberculosis with rapid and accurate diagnostic value.

关 键 词：结核感染T细胞斑点实验(T-SPOT.TB) 结核分枝杆菌DNA测定(TB-DNA) 结核菌素试验(TST) 肺结核 

分 类 号：R378.91[医药卫生—病原生物学]