结核感染T-Spot在不同CD4水平的AIDS合并结核感染的诊断价值  

Diagnostic Value of T-Spot.TB Test in AIDS Complicated with Tuberculosis at Different CD4 Levels

作　　者：张珍 杨学刚[1] Zhang Zhen;Yang Xuegang(Baoding Infectious Disease Hospital,Baoding 071000,China)

机构地区：[1]保定市传染病医院,河北保定071000

出　　处：《中国中西医结合皮肤性病学杂志》2020年第3期243-245,共3页Chinese Journal of Dermatovenereology of Integrated Traditional and Western Medicine

摘　　要：目的评价结核感染T细胞斑点试验(T-Spot.TB)诊断艾滋病(AIDS)合并结核感染的临床应用价值,以及不同的CD4+T淋巴细胞(简称CD4细胞)水平对T-Spot.TB检测的影响。方法采用回顾性分析,收集2016年1月-2018年9月医院收治AIDS患者中疑似结核感染或需要排除结核感染的患者临床和实验室信息,将临床诊断、T-Spot.TB检测结果、结核菌素纯蛋白衍生物(PPD)试验结果、CD4细胞水平进行分析。结果入选病例中诊断结核感染81例,排除结核感染160例,结核组中T-Spot.TB的阳性率为77.8%,显著高于非结核组11.8%,PPD试验在2组间的阳性率分别为14.8%和7.5%。结核组CD4细胞水平<50个/μL、50~200个μL、>200个/μL 3组的T-Spot.TB阳性率分别为73.0%、77.1%和85.0%,差别无统计学意义。结论相对于PPD检测,T-Spot.TB对AIDS合并结核感染的敏感性和特异性更高,有较高的临床诊断价值。Objective In order to evaluate the clinical value of T cells spot test of Tuberculosis infection(T-Spot.TB)test in diagnosis of patients with acquired immune deficiency syndrome(AIDS)complicated by tuberculosis and to analyze the CD4 levels on the detection of T-Spot.TB.Methods A retrospective study was conducted to collect the clinical and laboratoryrecords of hospitalized AIDS patients suspected of tuberculosis infection or need to be eliminated from tuberculosis fromJanuary 2016 to September 2018,and analyze clinical diagnosis,T-Spot. TB test results,tuberculin pure protein derivative(PPD) test results and CD4 cell levels. Results It was diagnosed that 81 cases of tuberculosis infection and 160 case oftuberculosis infection were excluded. The positive rate of T-spot. TB was 77.8% in the TB group,significantly higher than11.8% in the non-TB group,and the positive rate of PPD test was 14.8% and 7.5%. The TB patients were divided into lessthan 50,50~200 and more than 200 according to the CD4 cell counts,the positive rate of T-Spot. TB was 73.0%,77.1% and85.0%,the differences were not statistically significant (P>0.05). Conclusion As compared with PPD detection,T-Spot.TB hasa higher sensitivity and specificity to AIDS combined with tuberculosis infection,and it has higher clinical diagnostic value.

关 键 词：艾滋病 结核感染 结核感染T细胞斑点试验 结核菌素纯蛋白衍生物试验 CD4+T淋巴细胞计数 

分 类 号：R512.91[医药卫生—内科学]