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目的探讨结核感染T细胞斑点试验(T-SPOT.TB)在菌阳和菌阴结核病诊断中的临床价值和意义。方法回顾性分析759例菌阳结核、468例菌阴结核和606例非结核患者的T-SPOT.TB检测结果,总结该方法对菌阳和菌阴结核的诊断性能,同时比较T-SPOT.TB中抗原A和抗原B在结核诊断中的效果及一致性。结果 T-SPOT.TB在结核诊断中的总体敏感度为91.9%,特异性为82.0%;在菌阳和菌阴结核中敏感度分别为95.5%和85.9%。抗原A和抗原B的阳性率在菌阳、菌阴和非结核患者三组内差异均无统计学意义(P>0.05),但抗原A和抗原B在菌阳结核诊断中一致性较差,表现为抗原A具有更好的敏感度,抗原B则特异性更高。结论 T-SPOT.TB试验对菌阳和菌阴结核均有较好的诊断价值,抗原A和抗原B在诊断中各具优势,两者联合使用有利于提高结核病诊断效果。
Objective To investigate the clinical significance and significance of T-SPOT.TB in the diagnosis of Bacillus yang and Bacterin y tuberculosis. Methods The T-SPOT.TB test results of 759 cases of bacillary-positive tuberculosis, 468 cases of bacteriocin y tuberculosis and 606 cases of non-tuberculous tuberculosis were retrospectively analyzed. The diagnostic performance of this method on bacilli and fungus-negative tuberculosis was summarized. The T-SPOT was also compared. Effect and consistency of antigen A and antigen B in the diagnosis of tuberculosis in TB. Results The overall sensitivity and specificity of T-SPOT.TB in diagnosing tuberculosis were 91.9% and 82.0%, respectively. The sensitivity of T-SPOT.TB was 95.5% and 85.9% in the positive bacteria and negative bacteria, respectively. The positive rates of antigen A and antigen B were not significantly different between the three groups (P> 0.05), but the consistency of antigen A and antigen B in the diagnosis of bacillary positive pulmonary tuberculosis was poor, The performance of antigen A has a better sensitivity, antigen B is more specific. Conclusion The T-SPOT.TB test has good diagnostic value for both bacilli and bacteriamn y tuberculosis. Antigen A and antigen B have their own advantages in the diagnosis. The combination of the two can be helpful to improve the diagnosis of tuberculosis.