结核感染T细胞斑点试验中结核特异性抗原/植物血凝素比值对肺外结核的诊断价值  

Diagnostic value of mycobacterium tuberculosis specific antigen/phytohaemagglutinin ratio in tuberculosis infection T cell spot test for extrapulmonary tuberculosis

作　　者：黄健[1] 孙冰[1] 柴青峰[2] 韩伟[1] 崔秀琴[1] HUANG Jian;SUN Bing;CHAI Qingfeng;HAN Wei;CUI Xiuqin(Department of Tuberculosis,the First Affiliated Hospital of Xinxiang Medical University,Xinxiang Key Laboratory of Tuberculosis,Weihui 453100,Henan Province,China;Tuberculosis Research Institute,the First Affiliated Hospital of Xinxiang Medical University,Xinxiang Key Laboratory of Tuberculosis,Weihui 453100,Henan Province,China)

机构地区：[1]新乡医学院第一附属医院结核内科二病区,新乡市结核病学重点实验室,河南卫辉453100 [2]新乡医学院第一附属医院结核病研究所,新乡市结核病学重点实验室,河南卫辉453100

出　　处：《新乡医学院学报》2021年第2期176-179,共4页Journal of Xinxiang Medical University

摘　　要：目的探讨结核感染T细胞斑点试验(T-SPOT.TB)中结核特异性抗原(TBAg)/植物血凝素(PHA)比值在肺外结核(EPTB)诊断中的应用价值。方法选择2018年1月至2020年1月新乡医学院第一附属医院收治的522例疑诊的EPTB患者为研究对象,根据最终是否诊断为EPTB,将患者分为EPTB组(n=209)和非EPTB组(n=313)。2组患者均行T-SPOT.TB检测,比较2组患者T-SPOT.TB检测结果阳性率、PHA斑点形成细胞(sfc)数、早期分泌靶向抗原6(ESAT-6)sfc数、培养滤液蛋白10(CFP-10)sfc数及TBAg/PHA比值。比较ESAT-6 sfc数、CFP-10 sfc数及TBAg/PHA比值对EPTB的诊断价值。结果EPTB组和非EPTB组患者T-SPOT.TB检测结果阳性率分别为88.5%(185/209)和24.3%(76/313);EPTB组患者T-SPOT.TB检测结果阳性率显著高于非EPTB组(χ^(2)=206.840,P<0.05)。EPTB组患者T-SPOT.TB检测结果中ESAT-6 sfc数、CFP-10 sfc数、TBAg/PHA比值均显著高于非EPTB组,PHA sfc数显著低于非EPTB组(P<0.05)。根据受试者工作特征(ROC)曲线,TBAg/PHA比值诊断EPTB的特异度显著高于ESAT-6 sfc数和CFP-10 sfc数(P<0.05);ESAT-6 sfc数、CFP-10 sfc数、TBAg/PHA比值诊断EPTB的ROC曲线下面积和灵敏度比较差异无统计学意义(P>0.05)。结论TBAg/PHA比值可显著提高T-SPOT.TB诊断EPTB的特异度,在EPTB诊断中具有较好的应用前景。Objective To explore the application value of mycobacterium tuberculosis specific antigen(TBAg)/phytohaemagglutinin(PHA)ratio in tuberculosis infection T cell spot test(T-SPOT.TB)in the diagnosis of extrapulmonary tuberculosis(EPTB).Methods A tatol of 522 patients with suspected EPTB admitted to the First Affiliated Hospital of Xinxiang Medical University from January 2018 to January 2020 were selected as the research subjects.According to the final diagnosis of EPTB,the patients were divided into EPTB group(n=209)and non-EPTB group(n=313).The patients in the two groups were tested for T-SPOT.TB,the positive rate of T-SPOT.TB test results and the number of PHA spot forming cell(sfc),the number of early secretion antigenic target 6(ESAT-6)sfc,the number of culture filtrate protein-10(CFP-10)sfc and TBAg/PHA ratio were compared between the two groups.The diagnostic value of number of ESAT-6 sfc,number of CFP-10 sfc and TBAg/PHA ratio for EPTB were compared.Results The positive rates of T-SPOT.TB test results of patients in the EPTB group and non-EPTB group were 88.5%(185/209)and 24.3%(76/313)respectively;the positive rate of T-SPOT.TB test results of patients in the EPTB group was significantly higher than that in the non-EPTB group(χ^(2)=206.840,P<0.05).The number of ESAT-6 sfc,CFP-10 sfc and TBAg/PHA ratio in the T-SPOT.TB test results of patients in the EPTB group were significantly higher than those in the non-EPTB group,and the number of PHA sfc was significantly lower than that in the non-EPTB group(P<0.05).According to the receiver operation characteristic(ROC)curve,the specificity of TBAg/PHA ratio in diagnosing EPTB was significantly higher than that of the number of ESAT-6 sfc and CFP-10 sfc(P<0.05);there was no significant difference in the area under the ROC curve and sensitivity of the number of ESAT-6 sfc and CFP-10 sfc,TBAg/PHA ratio in the diagnosis of EPTB(P>0.05).Conclusion The TBAg/PHA ratio can significantly improve the specificity of T-SPOT.TB in the diagnosis of EPTB,and it has a good applica

关 键 词：肺外结核 结核感染T细胞斑点试验 结核特异性抗原/植物血凝素比值 

分 类 号：R446.61[医药卫生—诊断学]