不同检测技术在肺结核中的诊断效能分析  

Diagnostic performance of different detection techniques in pulmonary tuberculosis

作　　者：李梅 马荣 郑松 LI Mei;MA Rong;ZHENG Song(Department of Tuberculosis,Anhui Chest Hospital,Hefei,Anhui 230000,China)

机构地区：[1]安徽省胸科医院结核科,安徽合肥230000

出　　处：《临床肺科杂志》2023年第2期177-182,188,共7页Journal of Clinical Pulmonary Medicine

摘　　要：目的探究外周血结核感染T细胞斑点试验(T-SPOT.TB)、实时荧光核酸恒温扩增检测技术(SAT)及血清结核抗体(TB-Ab)检测对肺结核患者的诊断效能。方法选择本院2019年1月~2022年4月收治的155例疑似肺结核患者,按照不同年龄段将研究对象分为<60岁组和≥60岁组,以临床诊断为标准,分析T-SPOT.TB、SAT及TB-Ab检测在肺结核中的诊断效能。结果与临床诊断相比,单项检测中T-SPOT.TB对肺结核诊断效能最高,敏感度、特异度、准确度分别为84.47%、73.08%、80.65%,Kappa=0.570;联合检测中T-SPOT.TB+SAT+TB-Ab对肺结核诊断效能最高,敏感度、特异度、准确度为99.03%、63.46%、87.10%,Kappa=0.683。单项检测中T-SPOT.TB对<60岁、≥60岁的肺结核患者均具有中度诊断一致性,敏感度、特异度、准确度分别为84.34%、85.00%,75.00%、68.75%,81.51%、77.78%,Kappa=0.575、0.544;联合检测中T-SPOT.TB+SAT+TB-Ab对<60岁、≥60岁的肺结核患者均具有中度诊断一致性,敏感度、特异度、准确度分别为100.00%、95.00%,66.67%、56.25%,89.92%、77.78%,Kappa=0.736、0.532。结论联合检测可以提高早期肺结核的辅助诊断效能,T-SPOT.TB+SAT+TB-Ab效能最高,且对于<60岁的肺结核患者具有较好诊断价值。Objective To explore the diagnostic performance of peripheral blood tuberculosis infection of T cells spot test(T-SPOT.TB),real-time fluorescent nucleic acid simultaneous amplification and testing(SAT)and serum tuberculosis antibody(TB-Ab)detection in patients with pulmonary tuberculosis.Methods A total of 155 patients who were suspected of pulmonary tuberculosis and admitted to the hospital between January 2019 and April 2022 were selected.According to age,the subjects were divided into the<60-year-old group and the≥60-year-old group.Clinical diagnosis was taken as the standard to analyze the diagnostic performance of T-SPOT.TB,SAT and TB-Ab detection in pulmonary tuberculosis.Results Compared with clinical diagnosis,the diagnostic performance of T-SPOT.TB was the best in single diagnosis of pulmonary tuberculosis.Its sensitivity,specificity and accuracy were 84.47%,73.08%and 80.65%,respectively(Kappa=0.570).For combined detection,the diagnostic performance of T-SPOT.TB combined with SAT and TB-Ab was the best.The sensitivity,specificity and accuracy were 99.03%,63.46%and 87.10%,respectively(Kappa=0.683).For single diagnosis of both the<60-year-old group and the≥60-year-old group,T-SPOT.TB had medium consistency.The sensitivity,specificity and accuracy were 84.34%and 85.00%,75.00%and 68.75%,81.51%and 77.78%,respectively(Kappa=0.575,0.544).For combined diagnosis,T-SPOT.TB combined with SAT and TB-Ab had medium consistency in the diagnosis of both the<60-year-old group and the≥60-year-old group.The sensitivity,specificity and accuracy were 100.00%and 95.00%,66.67%and 56.25%,89.92%and 77.78%,respectively(Kappa=0.736,0.532).Conclusion The combined detection can improve the diagnosis of pulmonary tuberculosis.T-SPOT.TB combined with SAT and TB-Ab can achieve the best diagnostic performance,especially for patients under 60 years old.

关 键 词：肺结核 外周血结核感染T细胞斑点试验 实时荧光核酸恒温扩增检测技术 血清结核抗体检测 诊断 

分 类 号：R521[医药卫生—内科学] R446.5[医药卫生—临床医学]