云南地区T-SPOT.TB检测技术斑点计数与涂阳肺结核病人排菌量的相关性研究  

Correlation between T-SPOT.TB Detection Technique in Yunnan and the Amount of Bacteria in Smear-positive Pulmonary Tuberculosis Patients

作　　者：李才信 王霖 刘子龙 李晓琴 孟文卿 LI Cai-xin;WANG Lin;LIU Zi-long;LI Xiao-qin;MENG Wen-qing(Department of Clinical Laboratory,Changpo Hospital,Kunming Third People's Hospital,Kunming,Yunnan Province,650301 China)

机构地区：[1]昆明市第三人民医院长坡院区检验科

出　　处：《中外医疗》2019年第18期186-188,共3页China & Foreign Medical Treatment

摘　　要：目的探讨云南地区T-SPOT.TB检测技术斑点计数与涂阳肺结核病人排菌量的相关性。方法方便选取云南地区300例T-SPOT.TB检测技术斑点计数与涂阳肺结核病人,进行排菌量的相关性分析,探讨血清T-spot检测技术在肺结核诊断中的特异性和敏感性。结果活动性肺结核组观察到T细胞斑点为67.0(32.8,133.5),相比老年肺结核组5.0(1.0,18.5)。结核组中位T细胞斑点为85.0(37.0,140.0),相比肺外结核组40.4(8.0,106.0))(P=0.001)要高。试者工作特性曲线(ROC曲线)分析显示,在活动性结核组中T-SPOT.TB的ROC曲线下面积(0.887)大于抗原A(0.874)和抗原B(0.868),以T细胞斑点数25.5为最佳边界值,活动性结核分枝杆菌感染与潜伏性结核分枝杆菌感染(简称潜伏性结核感染)的鉴别,敏感性和特异性分别为79.9%和79.4%。结论①T细胞斑点数可反映体内的结核分枝杆菌负荷;②T-SPOT.TB在肺结核的诊断中具有较高的灵敏度和特异度。Objective To investigate the correlation between the spot count of T-SPOT.TB detection technology in Yunnan and the bacterial count of smear-positive pulmonary tuberculosis patients. Methods To convenient select the correlation between the T-SPOT.TB detection technique and the bacterial count of smear-positive pulmonary tuberculosis in 300 cases in Yunnan, and to explore the specificity and sensitivity of serum T-spot detection technology in the diagnosis of tuberculosis. Results T cell spots were observed in the active tuberculosis group at 67.0 (32.8, 133.5), which was much higher than in the elderly tuberculosis group 5.0(1.0,18.5)(P=0.000). The median T cell spot in the tuberculosis group was 85.0 (37.0, 140.0), which was higher than the extrapulmonary tuberculosis group 40.4 (8.0, 106.0) (P=0.001). The tester's operating characteristic curve (ROC curve) analysis showed that the area under the ROC curve of T-SPOT.TB in the active tuberculosis group (0.887) was larger than that of antigen A (0.874) and antigen B (0.868), and the number of T cells was 25.5. For the optimal boundary value, the identification, sensitivity and specificity of active M. tuberculosis infection and latent M. tuberculosis infection (abbreviated as latent tuberculosis infection) were 79.9% and 79.4%, respectively. Conclusion 1.The number of T cell spots can reflect the Mycobacterium tuberculosis load in vivo;2.T-SPOT.TB has higher sensitivity and specificity in the diagnosis of tuberculosis.

关 键 词：云南地区 T-SPOT.TB检测技术 斑点计数 肺结核病人 排菌量 相关性 

分 类 号：R521[医药卫生—内科学]