结核抗体 结核感染T细胞斑点试验及痰涂片 痰培养联合应用对活动性肺结核的诊断效能  

Diagnostic efficacy of combined application of tuberculosis antibody, T-SPOT.TB and sputum smear and sputum culture on active pulmonary tuberculosis

作　　者：牛思田 刘歆 Niu Sitian;Liu Xin(Department of Laboratory,Luoyang Dongfang People′s Hospital,Luoyang,Henan 471003,China)

机构地区：[1]河南省洛阳市东方人民医院检验科,河南洛阳471003

出　　处：《实用医技杂志》2023年第6期434-438,共5页Journal of Practical Medical Techniques

摘　　要：目的探究活动性肺结核患者应用结核抗体、结核感染T细胞斑点试验(T-SPOT.TB)及痰涂片、痰培养联合诊断的诊断效能。方法回顾性分析2021年3月至2023年3月洛阳市东方人民医院经过临床诊断确诊的120例活动性肺结核患者的临床资料,作为肺结核组,同期收治的101例非活动性肺结核患者作为非结核组,以临床最终诊断结果为金标准。对2组结核抗体、T-SPOT.TB、痰涂片、痰培养及两种、四种联合检测方式进行分析,统计并比较在不同检测方式下2组患者肺部结核分枝杆菌感染阳性率、特异度、敏感度。结果肺结核组结核抗体、T-SPOT.TB、痰涂片、痰培养阳性检出率为45.0%(54/120)、86.7%(104/120)、19.2%(23/120)、45.8%(55/120),非结核组结核抗体、T-SPOT.TB、痰涂片、痰培养阳性检出率分别为24.8%(25/101)、19.8%(20/101)、1.0%(1/101)、4.0%(4/101)(P<0.05);T-SPOT.TB阴性预测值、准确度、敏感度最高,痰涂片阳性预测值、特异度最高;肺结核组结核抗体+T-SPOT.TB、结核抗体+痰涂片、结核抗体+痰培养、T-SPOT.TB+痰涂片、T-SPOT.TB+痰培养、痰涂片+痰培养、结核抗体+T-SPOT.TB+痰涂片+痰培养阳性检出率为85.0%(102/120)、55.8%(67/120)、56.7%(68/120)、76.7%(92/120)、80.8%(97/120)、47.5%(57/120)、91.7%(110/120),非结核组结核抗体+T-SPOT.TB、结核抗体+痰涂片、结核抗体+痰培养、T-SPOT.TB+痰涂片、T-SPOT.TB+痰培养、痰涂片+痰培养、结核抗体+T-SPOT.TB+痰涂片+痰培养阳性检出率为34.6%(35/101)、31.7%(32/101)、33.7%(34/101)、21.8%(22/101)、26.7%(27/101)、3.0%(3/101)、55.4%(56/101)(P均<0.05);结核抗体+T-SPOT.TB+痰涂片+痰培养阴性预测值、敏感度最高,痰涂片+痰培养阳性预测值、特异度最高,T-SPOT.TB+痰涂片与T-SPOT.TB+痰培养准确度最高。结论活动性肺结核患者联合应用结核抗体、T-SPOT.TB及痰涂片、痰培养检测有较高的临床意义,可提高诊断效能。Objective To investigate the diagnostic efficacy of the combined diagnosis of tuberculosis antibody,T-cell spot test for tuberculosis infection(T-SPOT.TB)and sputum smear and sputum culture in patients with active pulmonary tuberculosis.Methods The clinical data of 120 patients with active pulmonary tuberculosis diagnosed after clinical diagnosis in Luoyang Dongfang People′s Hospital from March 2021 to March 2023 were retrospectively analyzed as the pulmonary tuberculosis group,and 101 patients with inactive pulmonary tuberculosis admitted during the same period were treated as the non-tuberculosis group,with the clinical diagnosis results as the gold standard.TB antibody,T-SPOT.TB,sputum smear,sputum culture and two or four combined methods were analyzed in the 2 groups,and the positive rate,specificity and sensitivity of pulmonary Mycobacterium tuberculosis infection of the 2 groups of patients were counted and compared under different testing methods.Results The positive detection rates of tuberculosis antibody,T-SPOT.TB,sputum smear,and sputum culture in the tuberculosis group were 45.0%(54/120),86.7%(104/120),19.2%(23/120),and 45.8%(55/120),and the positive detection rates of tuberculosis antibody,T-SPOT.TB,sputum smear,and sputum culture in the non-tuberculosis group were 24.8%(25/101),19.8%(20/101),1.0%(1/101),4.0%(4/101)(P<0.05);T-SPOT.TB negative predictive value,accuracy and sensitivity were the highest,and the sputum smear positive predictive value and specificity were the highest;TB antibody+T-SPOT.TB,TB antibody+sputum smear,TB antibody+sputum culture,T-SPOT.TB+sputum smear,T-SPOT.TB+sputum culture,sputum smear+sputum culture,and TB antibody+T-SPOT.TB+sputum smear+sputum culture positive detection rate were 85.0%(102/120),55.8%(67/120),56.7%(68/120),76.7%(92/120),80.8%(97/120),47.5%(57/120),91.7%(110/120),and in the non-tuberculosis group tuberculosis antibody+T-SPOT.TB,tuberculosis antibody+sputum smear,tuberculosis antibody+sputum culture,T-SPOT.TB+sputum smear,T-SPOT.TB+sputum culture,sputum sme

关 键 词：结核 肺 抗体 细菌 酶联免疫斑点测定 

分 类 号：R521[医药卫生—内科学]