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目的探讨结核杆菌感染T细胞酶联免疫斑点试验(T-SPOT.TB)检测在肺外结核病诊断中的应用价值。方法选取2015年本院收治的364例疑似肺外结核病病人作为研究对象,所有病人均接受结核杆菌培养与血T-SPOT.TB检测,以临床确诊结果作为对照,分析病人T-SPOT.TB检测结果与结核杆菌培养阳性结果两者间的符合率,评价其敏感度、特异度和准确度。结果 T-SPOT.TB的肺外结核病敏感度为82.7%、特异度94.7%、准确度87.6%,与结核杆菌培养的敏感度为44.4%、特异度100.0%、准确度67.3%比较,差异有统计学意义(P<0.05);T-SPOT.TB检测肺外结核病结果与临床诊断结果一致性为Kappa=0.75,结核菌培养与临床诊断结果一致性为Kappa=0.57。结论 T-SPOT.TB是敏感度和特异度较高的快速检测结核杆菌感染的方法。
Objective To investigate the value of T-SPOT.TB detection in the diagnosis of extra-pulmonary tuberculosis. Methods Totally 364 patients suspected of having extrapulmonary tuberculosis who were admitted to our hospital in 2015 were enrolled in this study. All patients were treated with Mycobacterium tuberculosis and blood T-SPOT.TB. The results of clinical diagnosis were used as control to analyze T-SPOT.TB test Results and Mycobacterium tuberculosis culture positive results between the two rates, evaluate the sensitivity, specificity and accuracy. Results The sensitivity, specificity and accuracy of T-SPOT.TB were 82.7%, 94.7% and 87.6%, respectively. The sensitivity and specificity of T-SPOT.TB were 44.4%, 100.0% and 67.3%, respectively Statistical significance (P <0.05). The consistency between T-SPOT.TB test for detecting extra-pulmonary tuberculosis and clinical diagnosis was Kappa = 0.75. The consistency of TB diagnosis and clinical diagnosis was Kappa = 0.57. Conclusion T-SPOT.TB is a sensitive and specific method for rapid detection of Mycobacterium tuberculosis infection.