重组结核杆菌融合蛋白在肺结核诊断中的应用价值  

作　　者：胡春燕 王丽洁 林晓明 邱超超 

机构地区：[1]浙江省温州市第六人民医院,325000

出　　处：《浙江临床医学》2025年第2期222-224,共3页Zhejiang Clinical Medical Journal

摘　　要：目的探讨重组结核杆菌融合蛋白(EC)皮试在肺结核诊断中的应用价值。方法收集自2023年6月至12月于本院收治的177例肺部影像学异常的疑似肺结核患者,根据皮试类型分为两组,观察组为EC皮试组,对照组为结核菌素皮肤实验(TST)皮试组。以临床诊断肺结核为标准,通过比较痰涂片抗酸染色、T-SPOT.TB、结核分枝杆菌培养、TST皮试、EC皮试等结果,分析EC皮试在肺结核诊断中的应用价值。结果以临床诊断肺结核为标准,上述检测技术中,EC皮试的敏感度最高为96.2%,其次为T-SPOT.TB的92.0%及TST皮试的89.8%。EC皮试阳性检出率明显高于抗酸染色及结核分枝杆菌培养,差异有统计学意义(χ^(2)=72.650,P<0.001、χ^(2)=26.828,P<0.001),与T-SPOT.TB比较,差异无统计学意义(χ^(2)=1.450,P=0.229),与抗酸染色联合结核分枝杆菌培养检测比较,差异有统计学意义(χ^(2)=21.687,P<0.001)。结论EC皮试对肺结核诊断的敏感度高显著高于抗酸染色及结核分枝杆菌培养,也高于抗酸染色联合结核分枝杆菌培养检测,在结核菌检测阴性的肺结核诊断中具有广泛的应用价值。Objective To explore the application value of the recombinant Mycobacterium tuberculosis fusion protein(EC)skin test in the diagnosis of pulmonary tuberculosis.Methods A retrospective collection of 177 suspected pulmonary tuberculosis patients with pulmonary imaging abnormalities admitted to our hospital from June 2023 to December 2023 was conducted.Patients were divided into 2 groups based on the type of skin test:the observation group for the EC skin test and the control group for the tuberculin skin test(TST).The clinical diagnosis of pulmonary tuberculosis was used as the standard,and the application value of the EC skin test in the diagnosis of pulmonary tuberculosis was analyzed by comparing the results of sputum smear acid-fast staining for bacilli,T-SPOT.TB,Mycobacterium tuberculosis culture,TST,and EC skin test.Results With the clinical diagnosis of pulmonary tuberculosis as the standard,among the above detection techniques,the sensitivity of the EC skin test was the highest at 76(96.2%),followed by T-SPOT.TB at 127(92.0%)and TST at 53(89.8%).The positive detection rate of the EC skin test was significantly higher than that of acid-fast staining and Mycobacterium tuberculosis culture,with statistically significant differences(χ^(2)=72.650,P<0.001;χ^(2)=26.828,P<0.001).Compared with T-SPOT.TB,there was no statistically significant difference(χ^(2)=1.450,P=0.229).Compared with the combined detection of acid-fast staining and Mycobacterium tuberculosis culture,there was a statistically significant difference(χ^(2)=21.687,P<0.001).Conclusion The EC skin test has a high sensitivity for the diagnosis of pulmonary tuberculosis,significantly higher than acid-fast staining and Mycobacterium tuberculosis culture,as well as higher than the combined detection of acid-fast staining and Mycobacterium tuberculosis culture.It has a wide application value in the diagnosis of pulmonary tuberculosis with negative bacterial testing.

关 键 词：EC皮试 肺结核 T-SPOT.TB 诊断价值 

分 类 号：R521[医药卫生—内科学]