外周血T-SPOT.TB和38kD-IgG检测在活动期结核病诊断中的应用  

Application of peripheral blood T-SPOT.TB and 38kD-IgG in the diagnosis of active tuberculosis

作　　者：王永锋 徐焰 WANG Yong-feng;XU Yan(Department of Clinical Laboratory,Xi'an Daxing Hospital,Xi'an 710016,Shaanxi,CHINA)

机构地区：[1]西安大兴医院检验科,陕西西安710016

出　　处：《海南医学》2021年第1期35-38,共4页Hainan Medical Journal

摘　　要：目的探讨外周血结核感染T细胞(T-SPOT.TB)及抗结核抗体G(38kD-IgG)检测结果在活动期结核病患者诊断中的应用价值。方法回顾性分析西安大兴医院于2017年8月至2019年11月收治的141例结核病患者的诊疗情况。按照最终诊断结果将患者分为活动期结核病组97例及非活动期结核病组44例,另选择同期在我院体检的60例健康体检者为对照组。比较三组受检者的T-SPOT.TB、38kD-IgG试验检测结果及活动期结核病组、非活动期结核病组患者的T-SPOT.TB斑点计数[B抗原滤液培养蛋白10(CFP10)、A抗原早期分泌性靶抗原6(ESAT6);分析T-SPOT.TB、38kD-IgG试验对活动期结核病的诊断效能。结果活动期结核病组患者的T-SPOT.TB阳性率和38kD-IgG阳性率分别为90.72%、74.23%,均明显高于非活动期结核病组的77.27%、54.55%和对照组的8.33%、6.67%,非活动期结核病组的T-SPOT.TB阳性率和38kD-IgG阳性率明显高于对照组,差异均有统计学意义(P<0.05);T-SPOT.TB试验在诊断活动期结核病上的敏感度、特异度、准确度及阳性预测值和阴性预测值分别为90.72%、77.27%、86.52%、89.90%和79.07%,明显高于38kD-IgG试验的74.23%、54.55%、68.09%、78.26%和48.98%,差异均有统计学意义(P<0.05);活动期结核病组患者的CFP10、ESAT6合并CFP10斑点计数分别为(60.46±13.84)个/孔、(86.24±20.92)个/孔,均明显高于非活动期结核病组患者的(41.27±9.38)个/孔、(68.31±18.33)个/孔,差异均有统计学意义(P<0.05)。结论外周血T-SPOT.TB试验和38kD-IgG试验在诊断活动期结核病上均具有一定诊断价值,但T-SPOT.TB试验的诊断准确率更高。此外,T-SPOT.TB斑点计数越高,提示活动期结核病的可能性越大。Objective To compare Mycobacterium tuberculosis antigen-specific IFN-γrelease assays(T-SPOT.TB)and anti-tuberculosis antibody G(38kD-IgG)detection results in patients with active tuberculosis,to study the diagnostic value of them in the diagnosis of active tuberculosis.Methods The diagnosis and treatment of 141 tuberculosis patients admitted to Xi'an Daxing Hospital from August 2017 to November 2019 were retrospectively analyzed.According to the final diagnosis results,the patients were divided into 97 active tuberculosis patients(as active tuberculosis group)and 44 inactive tuberculosis patients(as inactive tuberculosis group).In addition,60 healthy volunteers were selected as the control group.The test results of T-SPOT.TB,38kD-IgG in active tuberculosis group,inactive tuberculosis group,and control group were compared;the diagnostic efficiency of T-SPOT.TB,38kD-IgG in the diagnosis of active tuberculosis were compared;the T-SPOT.TB spot count(B antigen filtrate culture protein 10[CFP10],A antigen early secretory target antigen 6[ESAT6])of active tuberculosis group and inactive tuberculosis group were compared.Results The positive rates T-SPOT.TB and 38kD-IgG in patients with active tuberculosis were 90.72%and 74.23%respectively,which were significantly higher than 77.27%,54.55%in the inactive tuberculosis group and 8.33%,6.67%in the control group,and the positive rates of T-SPOT.TB and 38kD-IgG in the inactive tuberculosis group were significantly higher than those of the control group,with statistically significant differences(all P<0.05);the sensitivity,specificity,accuracy,positive predictive value,and negative predictive value of T-SPOT.TB test were 90.72%,77.27%,86.52%,89.90%,and 79.07%respectively,which were significantly higher than corresponding 74.23%,54.55%,68.09%,78.26%,and 48.98%of 38kD-IgG test(all P<0.05);the CFP10 and ESAT6 combined with CFP10 spot count in active tuberculosis group were(60.46±13.84)spots/holes and(86.24±20.92)spots/holes,which were significantly higher than(41.27±9.38)spots

关 键 词：活动期结核病 结核分枝杆菌 结核感染T细胞 斑点试验 抗结核抗体 

分 类 号：R52[医药卫生—内科学]