CAJ | 학술논문

目的：探讨结核感染T细胞斑点试验（ T-SPOT. TB）中AB两种抗原检测结果在临床结核感染患者诊断中的意义。方法选取2013年6~11月住院治疗并最终确诊活动性结核的96例患者为研究对象，采集其外周血进行 T-SPOT. TB检测，将检测结果与结核菌素试验（ PPD）及最终诊断结果进行对比，并对AB两种抗原检出结果的一致性及其阳性斑点分布特点进行分析。结果 T-SPOT. TB灵敏度为97.9%，特异度为87.8%，准确度为94.5%，阳性预测值（PPV）为94.0%，阴性预测值（NPV）为95.6%，均显著高于PPD检测结果（ P <0.01）。T-SPOT. TB两种抗原A和B对检测结果阳性率无统计差异，阳性斑点分布特征分析显示抗原A阳性斑点数与结核活动性呈正相关趋势，有较高的特异度；而抗原B则分别在高、低阳性斑点区呈现活动性结核检出的高峰，具有更好的敏感度。结论 T-SPOT. TB试验对活动性结核诊断有高度的敏感度和特异度，且AB两种抗原表现出不同的阳性检出规律和意义。T-SPOT. TB试验可为临床结核病的筛查和大规模流行病学调查提供新的技术分析手段。
목적：탐토결핵감염T세포반점시험（ T-SPOT. TB）중AB량충항원검측결과재림상결핵감염환자진단중적의의。방법선취2013년6~11월주원치료병최종학진활동성결핵적96례환자위연구대상，채집기외주혈진행 T-SPOT. TB검측，장검측결과여결핵균소시험（ PPD）급최종진단결과진행대비，병대AB량충항원검출결과적일치성급기양성반점분포특점진행분석。결과 T-SPOT. TB령민도위97.9%，특이도위87.8%，준학도위94.5%，양성예측치（PPV）위94.0%，음성예측치（NPV）위95.6%，균현저고우PPD검측결과（ P <0.01）。T-SPOT. TB량충항원A화B대검측결과양성솔무통계차이，양성반점분포특정분석현시항원A양성반점수여결핵활동성정정상관추세，유교고적특이도；이항원B칙분별재고、저양성반점구정현활동성결핵검출적고봉，구유경호적민감도。결론 T-SPOT. TB시험대활동성결핵진단유고도적민감도화특이도，차AB량충항원표현출불동적양성검출규률화의의。T-SPOT. TB시험가위림상결핵병적사사화대규모류행병학조사제공신적기술분석수단。
Objective To investigate the application value of mycobacterium tuberculosis T cell enzyme-linked immunospot tuberculous test( T-SPOT TB test)in tuberculosis diagnosis and tuberculosis infection diagnosis. Methods Peripheral blood( PB)samples were collected from 96 cases of active tuberculosis patients( case group)and 49 cases of non-tuberculosis( control group)respectively. A spot test using T lym-phocytes infected with mycobacterium tuberculosis( T-SPOT. TB)was applied to detect the T lymphocytes in PB samples. The sensitivity and specificity for diagnosing tuberculosis by this method were evaluated. Results Compared with PPD assay,PB mononuclear cells T-SPOT. TB as-say showed that the sensitivity and specificity were 97. 9% and 87. 8%;accuracy rate was 94. 5%;positive predictive value was 94. 0%;negative predictive value was 95. 6%. PPD assay showed that the sensitivity and specificity were 81. 8% and 85. 7%;accuracy rate was 84. 1%;positive predictive value was 79. 4%;negative predictive value was 87. 5%. Furthermore,there was no statistical difference between antigens A and B on the positive rate of tuberculosis diagnosis. However antigen A exhibited a higher specificity,whereas antigen B with a better sensitivity. Conclu-sion PB mononuclear cells T-SPOT. TB assay is favorable for the current diagnosis of tuberculosis as auxiliary diagnostic methods. The two anti-gens A and B showed different patterns and significance of positive detection. This method could be better used for screening and large-scale clin-ical epidemiological investigation of tuberculosis.