人免疫缺陷病毒/结核分枝杆菌混合感染应用T细胞斑点试验诊断的价值  

Value of T-SPOT.TB in the diagnosis of HIV/TB mixed infection

作　　者：崔中锋 刘春礼[1] 王丽花 李格[1] 李广明[1] CUI Zhong-feng;LIU Chun-li;WANG Li-hua;LI Ge;LI Guang-ming(Zhengzhou Sixth People's Hospital(Henan Provincial Hospital of Infectious Diseases),Zhengzhou,Henan 450000,China)

机构地区：[1]郑州市第六人民医院(河南省传染病医院),河南郑州450000

出　　处：《中国卫生检验杂志》2020年第24期2948-2950,共3页Chinese Journal of Health Laboratory Technology

基　　金：2014河南省医学科技攻关计划普通项目(201403244)。

摘　　要：目的探讨人免疫缺陷病毒(HIV)/结核分枝杆菌(TB)混合感染者CD4+T淋巴细胞水平对T-SPOT.TB检测的影响。方法选取2017年1月-2019年2月在本院治疗的HIV/TB感染患者142例(HIV/TB组),单纯TB感染患者130例(TB组),均给予T-SPOT.TB检测。结果 HIV/TB组和TB组T-SPOT.TB检出阳性率差异无统计学意义(P> 0.05);T-SPOT.TB诊断TB感染的灵敏度、特异度、阳性预测值和阴性预测值分别为76.06%、80.00%、85.71%和67.92%;HIV/TB组肺结核和肺外结核T-SPOT.TB检出阳性率差异无统计学意义(P> 0.05);TB组肺结核和肺外结核T-SPOT.TB检出阳性率差异无统计学意义(P> 0.05);HIV/TB组CD4^+T淋巴细胞> 200个/L患者T-SPOT.TB检出阳性率为88.16%,明显高于CD4^+T淋巴细胞≤200个/L患者(P <0.05)。结论 HIV/TB混合感染应用TSPOT.TB诊断有较好的价值,但患者CD4^+T淋巴细胞水平对T-SPOT.TB检测有一定的影响。Objective To investigate the effect of CD4+T lymphocyte level on T-SPOT.TB detection in HIV/TB mixed infection patients.Methods A total of 142 patients with HIV/TB infection in our hospital from January 2017 to February 2019( HIV/TB group) and 130 patients with TB infection( TB group) were selected for T-SPOT.TB test.Results There was no statistical significance on the difference in the positive rate of T-SPOT.TB between HIV/TB group and TB group( P > 0.05).The sensitivity,specificity,positive predictive value and negative predictive value of T-SPOT.TB in the diagnosis of TB infection were 76.06%,80.00%,85.71% and 67.92%.There was no statistical significance on the difference in the positive rate of tuberculosis and extrapulmonary tuberculosis in the HIV/TB group( P > 0.05).There was no statistical significance on the difference in the positive rate of TB between TB group and TB group( P > 0.05).The positive rate of T-SPOT.TB was88.16% in patients with CD4^+T lymphocytes > 200 cell/L in HIV/TB group,significantly higher than that of CD4^+T lymphocytes ≤200 cell/L( P < 0.05).Conclusion T-SPOT.TB has a good value in the diagnosis of HIV/TB mixed infection,but the level of CD4^+T lymphocyte has a certain influence on the detection of T-SPOT.TB.

关 键 词：人免疫缺陷病毒 结核分枝杆菌 CD4^+T淋巴细胞 T细胞斑点试验 

分 类 号：R446.5[医药卫生—诊断学]