中国实用医刊
中國實用醫刊
중국실용의간
CENTRAL PLAINS MEDICAL JOURNAL
2015年
8期
24-25
,共2页
结核感染T细胞斑点试验%结核菌素试验%结核%诊断
結覈感染T細胞斑點試驗%結覈菌素試驗%結覈%診斷
결핵감염T세포반점시험%결핵균소시험%결핵%진단
TB infection of T cells spot test%Purified protein derivative tuberculin%Tuberculosis%Diagnosis
目的 比较结核诊断中结核感染T细胞斑点试验(TSPOT.TB)和结核菌素试验(PPD)的特异性和敏感性,探讨诊断价值.方法 本次选取45例疑患结核患者作为研究对象,收集临床资料,开展前瞻性研究,实施PPD和TSPOT.TB,并与对照组40例健康体检者比较其特异性、敏感性.结果 8例肺结核患者中,TSPOT.TB阳性率为100％(8/8),明显高于PPD阳性率62.5％ (5/8) (P ＜0.05).肺外结核6例中,TSPOT.TB阳性率达83.3％(5/6),高于PPD 66.7％ (4/6),但差异未见统计学意义(P＜0.05).TSPOT.TB准确度、NPV、PPV、特异性、敏感性均较明显高于PPD(P ＜0.05);LR-值TSPOT.TB明显低于PPD,LR±值TSPOT.TB明显高于PPD.38kD-lgG试验敏感性为73.3％,TSPOT-TB特异性为93.3％;菌阳者和菌阴者联合检测阳性率均数为95.6％.对照组38kD-lg-G特异性为70％,TSPOT-TB特异性为95％,差异有统计学意义(P＜0.05),实施联合检测,特异性为65％.结论 结核诊断中,TSPOT.TB的特异性和敏感性较PPD更强,在结核筛检试验、排除诊断和检测中更为适合.同时,免疫抑制对TSPOT.TB产生的抑制影响较小,可作为具此类危险因素的隐匿性结核患者临床筛查项目,以提高诊断水平.
目的 比較結覈診斷中結覈感染T細胞斑點試驗(TSPOT.TB)和結覈菌素試驗(PPD)的特異性和敏感性,探討診斷價值.方法 本次選取45例疑患結覈患者作為研究對象,收集臨床資料,開展前瞻性研究,實施PPD和TSPOT.TB,併與對照組40例健康體檢者比較其特異性、敏感性.結果 8例肺結覈患者中,TSPOT.TB暘性率為100％(8/8),明顯高于PPD暘性率62.5％ (5/8) (P ＜0.05).肺外結覈6例中,TSPOT.TB暘性率達83.3％(5/6),高于PPD 66.7％ (4/6),但差異未見統計學意義(P＜0.05).TSPOT.TB準確度、NPV、PPV、特異性、敏感性均較明顯高于PPD(P ＜0.05);LR-值TSPOT.TB明顯低于PPD,LR±值TSPOT.TB明顯高于PPD.38kD-lgG試驗敏感性為73.3％,TSPOT-TB特異性為93.3％;菌暘者和菌陰者聯閤檢測暘性率均數為95.6％.對照組38kD-lg-G特異性為70％,TSPOT-TB特異性為95％,差異有統計學意義(P＜0.05),實施聯閤檢測,特異性為65％.結論 結覈診斷中,TSPOT.TB的特異性和敏感性較PPD更彊,在結覈篩檢試驗、排除診斷和檢測中更為適閤.同時,免疫抑製對TSPOT.TB產生的抑製影響較小,可作為具此類危險因素的隱匿性結覈患者臨床篩查項目,以提高診斷水平.
목적 비교결핵진단중결핵감염T세포반점시험(TSPOT.TB)화결핵균소시험(PPD)적특이성화민감성,탐토진단개치.방법 본차선취45례의환결핵환자작위연구대상,수집림상자료,개전전첨성연구,실시PPD화TSPOT.TB,병여대조조40례건강체검자비교기특이성、민감성.결과 8례폐결핵환자중,TSPOT.TB양성솔위100％(8/8),명현고우PPD양성솔62.5％ (5/8) (P ＜0.05).폐외결핵6례중,TSPOT.TB양성솔체83.3％(5/6),고우PPD 66.7％ (4/6),단차이미견통계학의의(P＜0.05).TSPOT.TB준학도、NPV、PPV、특이성、민감성균교명현고우PPD(P ＜0.05);LR-치TSPOT.TB명현저우PPD,LR±치TSPOT.TB명현고우PPD.38kD-lgG시험민감성위73.3％,TSPOT-TB특이성위93.3％;균양자화균음자연합검측양성솔균수위95.6％.대조조38kD-lg-G특이성위70％,TSPOT-TB특이성위95％,차이유통계학의의(P＜0.05),실시연합검측,특이성위65％.결론 결핵진단중,TSPOT.TB적특이성화민감성교PPD경강,재결핵사검시험、배제진단화검측중경위괄합.동시,면역억제대TSPOT.TB산생적억제영향교소,가작위구차류위험인소적은닉성결핵환자림상사사항목,이제고진단수평.
Objective To compare the sensitivity and specificity of TSPOT.TB and PPD.Methods Forty-five suspected tuberculosis and 40 health examination cases were selected.Purified protein derivative tuberculin (PPD) and TB infection of T cells spot test (TSPOT.TB) were conducted and their sensitivity and specificity were compared.Results Among the 8 tuberculosis patients,TSPOT.TB positive rate was 100％ (8/8),which was significantly higher than PPD-positive rate (62.5％,5/8) (P ＜0.05).The TSPOT.TB positive rate (83.3％,5/6) of 6 cases of extrapulmonary tuberculosis was higher than PPD (66.7％,4/6),but the difference was not significant(P ＜0.05).The accuracy,NPV,PPV,specificity and sensitivity of TSPOT.TB was significantly higher than that of PPD (P ＜ 0.05) ; LR-value of TSPOT.TB was significantly lower than that of PPD and LR + value of TSPOT.TB was significantly higher than that of PPD.The sensitivity of 38kD-IgG test was 73.3％,and the specificity of TSPOT-TB was 93.3％ ; the bacteria positive and negative patients combined testing positive rate was 95.6％.The specificity of 38kD-IgG in control group was 70％ and specificity of TSPOT-TB was 95％,and the difference was significant (P ＜0.05),the specificity of the combined detection was 65％.Conclusions In terms of TB diagnosis,the sensitivity and specificity of TSPOT.TB was higher than that of PPD,accordingly TSPOT.TB is more effective on the screening,diagnosis and detection of tuberculosis.Meanwhile,the immunosuppression can less interfere TSPOT.TB,so it can be used among the suspected tuberculosis population.
