结核感染T淋巴细胞γ干扰素释放试验在骨关节结核诊断中的应用  

Application of interferon-gamma release assay in the diagnosis of bone and joint tuberculosis

作　　者：葛肖肖 彭灿辉[1] Ge Xiaoxia;Peng Canhui(Department of Clinical Laboratory,the Third Xiangya Hospital,Central South University,Changsha 410013,China;Xiangya Hospital Central South University,Changsha 410008,China)

机构地区：[1]中南大学湘雅三医院检验科,长沙410013 [2]中南大学湘雅医学院,长沙410008

出　　处：《中华临床实验室管理电子杂志》2018年第3期153-156,共4页Chinese Journal of Clinical Laboratory Management(Electronic Edition）

摘　　要：目的探讨结核感染T淋巴细胞γ干扰素释放试验(斑点试验,T-SPOT.TB)在骨关节结核中的应用价值。方法回顾性分析2016年1月至2018年3月在我院骨外科行T-SPOT.TB检测的127疑似骨关节结核感染病例,分析T-SPOT.TB在骨关节结核中的诊断性能;比较在不同部位骨关节结核的阳性率差异;同时比较以早期分泌抗原靶6(early secreted antigenic target 6,ESAT-6)和培养滤液蛋白10(culture filtrate protein 10,CFP-10)诊断骨关节结核的阳性率差异。结果 T-SPOT.TB检测的正确率、灵敏度、特异度、阳性预测值、阴性预测值分别为86.61%(110/127)、83.33%(35/42)、88.24%(75/85)、77.78%(35/45)、91.46%(75/82);且在不同类型骨关节结核的阳性率差别无统计学意义(χ~2=1.72,P>0.05);单独以ESAT-6和CFP-10抗原的点数诊断骨关节结核阳性率为69.04%、61.90%,差异无统计学意义(χ~2=0.27,P>0.05),两者联合诊断阳性率(83.33%)均高于ESAT-6和CFP-10抗原单独诊断的阳性率,差异有统计学意义(χ~2=4.16、7.11,P<0.05)。结论 T-SPOT.TB在骨关节结核诊断中具有重要的应用价值,值得临床推广。Objective To investigate the value of interferon-gamma release assays（T-SPOT.TB） in bone and joint tuberculosis. Methods A retrospective study of 127 suspected cases of bone joint tuberculosis in bone surgery in our hospital from January 2016 to March 2018 was conducted to analyze the diagnostic performance of T-SPOT.TB, and to compare the positive rate of tuberculosis in different bone and joint parts, and at the same time compared efficiency of the early secretory antigen target 6（ESAT-6） and culture filtrate protein 10（CFP-10） in diagnosing osteoarticular tuberculosis. Results The accuracy, sensitivity, specificity, positive predictive value and negative predictive value of T-SPOT.TB were 86.61%（110/127）, 83.33%（35/42）, 88.24%（75/85）, 77.78%（35/45） and 91.46%（75/82）, respectively. There were no significant differences of positive rate of T-SPOT.TB among the groups（χ^2=1.72, P〉0.05）. The positive rate were 69.04% and 61.90% when using ESAT-6 and CFP-10 assays（χ^2=0.27, P〉0.05）, while combination of of ESAT-6 and CFP-10 as diagnostic markers made the positive rate increase to 83.33%, higher than that using single one（χ^2=4.16, 7.11, P〈0.05）. Conclusion T-SPOT.TB has important application value in the diagnosis of bone and joint tuberculosis and deserves clinical promotion.

关 键 词：骨关节结核 T淋巴细胞γ干扰素释放试验 

分 类 号：R529.2[医药卫生—内科学]