结核T细胞斑点试验联合外周血T淋巴细胞亚群检测在临床诊断中的价值  

Value of tuberculosis T cell spot test combined with peripheral blood T lymphocyte subsets detection in clinical diagnosis

作　　者：陈志祥 艾克拜尔[1] 陈存存 车勇 Chen Zhixiang;Aikebaier;Chen Cuncun;Che Yong(The Eighth Affiliated Hospital of Xinjiang Medical University,Urumqi 830000,Xinjiang,China)

机构地区：[1]新疆医科大学第八附属医院胸外科,新疆乌鲁木齐830000

出　　处：《贵州医药》2024年第11期1683-1686,共4页Guizhou Medical Journal

基　　金：省部共建中亚高发病成因与防治国家重点实验室开放课题(SKL-HIDCA-2021-BF7)。

摘　　要：目的探讨结核T细胞斑点试验(T-SPOT.TB)联合外周血T淋巴细胞亚群检测在结核患者中的诊断价值。方法回顾性分析本院就诊的279例患者的临床资料。依据诊断标准分为结核组147例、非结核组132例,评估T-SPOT.TB与外周血T淋巴细胞亚群检测对结核病的诊断价值。结果结核组T-SPOT.TB阳性率高于非结核组(P<0.01);肺结核组患者CD3^(+)、CD4^(+)及CD8^(+)较非结核组相比有下降(P<0.05),CD4^(+)/CD8^(+)较非结核组变化不明显(P>0.05);两者联合检测受试者工作特征曲线下面积(AUC)为0.354(P<0.01),灵敏度90.48%,特异性38.64%,约登指数为0.291。结论T-SPOT.TB和外周血T淋巴细胞亚群检测诊断肺结核具有较高灵敏度,但在对结核和非结核的鉴别诊断中特异性降低,在临床中对结核的诊断价值有一定的意义,是对肺结核诊断的有效补充。Objective To explore the diagnostic value of tuberculosis T cell spot test combined with peripheral blood T lymphocyte subpopulation detection in tuberculosis patients.Methods The clinical data of 279 patients who in our hospital were retrospectively analyzed.According to the diagnostic criteria,147 cases were divided into tuberculosis group and 132 cases were divided into non-tuberculosis group.Diagnostic value of T-SPOT.TB and T lymphocyte subsets in peripheral blood for tuberculosis was evaluated.Result The positive rate of T-SPOT.TB in the tuberculosis group was higher than that in the non-tuberculosis group,and there were statistically significant differences(P<0.01).The levels of CD3^(+),CD4^(+),and CD8^(+)in the pulmonary tuberculosis group decreased compared to the non-tuberculosis group,and there were statistically significant differences(P<0.05).The changes in CD4^(+)/CD8^(+)were not significant compared to the non-tuberculosis group,and there were no statistically significant differences(P>0.05).The area under the working characteristic curve(AUC)of the two combined detection subjects is 0.354(P<0.01),sensitivity was 90.48%and specificity was 38.64%,and Jordan index 0.291.Conclusion The detection of T-SPOT.TB and peripheral blood T-lymphocyte subpopulations has high sensitivity in the diagnosis of pulmonary tuberculosis,but its specificity is reduced in the differential diagnosis of tuberculosis and non-tuberculosis.It has certain clinical significance for the diagnosis of tuberculosis and is an effective supplement for the diagnosis of pulmonary tuberculosis.

关 键 词：结核T细胞斑点试验 外周血T淋巴细胞亚群检测 肺结核 诊断 

分 类 号：R521[医药卫生—内科学]