结核抗体和结核感染T细胞斑点试验对结核感染的诊断价值  

Diagnostic value of tuberculosis antibody and tuberculosis infection T cell spot test in tuberculosis infection

作　　者：吴李萍[1] 龙虹宇 何羽 卿克勤[1] 李红霞 WU Liping;LONG Hongyu;HE Yu;QING Keqin;LI Hongxia(Department of Medical Laboratory,Chengdu First People's Hospital,Chengdu,Sichuan 610041,China;Hyperbaric Oxygen Treatment Center,Chengdu First People's Hospital,Chengdu,Sichuan 610041,China;College of Laboratory Medicine,Chongqing Medical University,Chongqing 400042,China)

机构地区：[1]成都市第一人民医院检验科,四川成都610041 [2]成都市第一人民医院高压氧治疗中心,四川成都610041 [3]重庆医科大学检验医学院,重庆400042

出　　处：《医药前沿》2024年第16期48-52,共5页Journal of Frontiers of Medicine

基　　金：成都市卫生健康委医学科研课题(2020183)。

摘　　要：目的:分析结核患者感染特点及流行趋势,探讨结核抗体(TB-Ab)和结核感染T细胞斑点试验(T-SPOT.TB)检测在结核感染中的诊断价值。方法:收集2016—2022年成都市第一人民医院就诊患者的抗酸染色、TB-Ab及T-SPOT.TB检测结果,共纳入261例患者,根据抗酸染色结果分为菌阳组(93例抗酸染色结核杆菌阳性肺结核患者)、菌阴组(84例结核杆菌阴性结核患者)、对照组(84例非结核病患者)。收集患者的年龄、性别、科室等相关信息,比较抗酸染色、TB-Ab、T-SPOT.TB结果,分析TB-Ab、T-SPOT.TB单独与联合诊断结核病的价值。结果:本院患者抗酸染色阳性检出率为0.88%,TB-Ab阳性率为6.23%,T细胞斑点试验阳性率为49.27%。菌阳组和菌阴组TB-Ab及T-SPOT.TB阳性检出率比较,差异无统计学意义(P>0.05);但两组分别与对照组比较,差异有统计学意义(P<0.05)。受试者工作特征(ROC)曲线分析显示,TB-Ab的ROC曲线下面积(AUC)为0.663[95%CI:(0.596,0.730)];T-SPOT.TB为0.725[95%CI:(0.656,0.795)],两者联合诊断的AUC为0.778[95%CI:(0.715,0.814)]。结论:抗酸染色为结核感染确诊的金标准,但敏感度较低,免疫学检测可有效补充其诊断能力。TB-Ab与T-SPOT.TB联合检测可提高结核感染诊断的效果,可用于临床中结核感染的辅助诊断。Objective To analyze the infection characteristics and epidemic trends of tuberculosis patients in our hospital,and to explore the diagnostic value of tuberculosis antibody(TB-Ab)and tuberculosis infection T cell spot test(T-SPOT.TB)detection in tuberculosis infection.Methods Retrospective collection of acid fast staining,TB-Ab,and T-SPOT.TB data from patients treated at Chengdu First People's Hospital from 2016 to 2022 According to the results of TB test,261 patients were included and divided into bacterial positive group(93 cases of TB patients with positive acid fast stain TB bacilli),bacterial negative group(84 cases of TB patients with negative TB bacilli)and control group(84 cases of non tuberculosis patients).Collected relevant information on the patient's age,gender,department,etc.,and compared with acid fast staining,TB-Ab,T-SPOT.TB results,analyzed the value of TB-Ab,T-SPOT.TB diagnosis alone and jointly for tuberculosis.Results The positive detection rate of acid fast staining in patients in our hospital was 0.88%,the positive rate of tuberculosis antibody was 6.23%,and the positive rate of T cell spot test was 49.27%.The comparison of positive detection rates of TB Ab and T-SPOT.TB in the bacterial positive and negative groups showed no statistically significant difference(P>0.05),but the difference between the two groups and the control group was statistically significant(P<0.05).According to the receiver operating characteristic(ROC)curve analysis,the area under curve(AUC)of ROC of TB-Ab was 0.663[95%CI:(0.596,0.730)];T-SPOT.TB was 0.725[95%CI:(0.656,0.795)],and the AUC for combined diagnosis of the two was 0.778[95%CI:(0.715,0.814)].Conclusions The acid-fast staining is the gold standard for the diagnosis of tuberculosis infection,but its sensitivity is low.Immunological testing can effectively supplement its diagnostic ability.The combination of TB-Ab and T-SPOT.TB detection can effectively improve the diagnostic efficiency of tuberculosis infection and can be used as an auxiliary diagnosis for tu

关 键 词：结核感染 结核抗体 结核感染T细胞斑点试验 

分 类 号：R52[医药卫生—内科学]