中国骨科临床与基础研究杂志
中國骨科臨床與基礎研究雜誌
중국골과림상여기출연구잡지
CHINESE JOURNAL OF CLINICAL AND BASIC ORTHO[AEDIC RESEARCH
2015年
2期
74-78
,共5页
结核,脊柱%诊断%分枝杆菌,结核%结核菌素试验%干扰素Ⅱ型%T淋巴细胞%免疫测定%敏感性与特异性
結覈,脊柱%診斷%分枝桿菌,結覈%結覈菌素試驗%榦擾素Ⅱ型%T淋巴細胞%免疫測定%敏感性與特異性
결핵,척주%진단%분지간균,결핵%결핵균소시험%간우소Ⅱ형%T림파세포%면역측정%민감성여특이성
Tuberculosis,spinal%Diagnosis%Mycobacterium tuberculosis%Tuberculin test%Interferon typeⅡ%T-lymphocytes%Immunoassay%Sensitivity and specificity
目的：探讨结核感染T细胞斑点（T-SPOT.TB）检测在脊柱结核诊断中的应用价值。方法对2012年1月至2014年10月郑州市骨科医院收治的110例疑似脊柱结核病例同时进行结核菌素皮试试验（TST）及T-SPOT.TB检查，其中TST分别采用红肿硬结直径≥5 mm和≥15 mm两种标准，标记为TST 5和TST 15。以临床诊断结果作为标准，对比分析上述检测方法的敏感度、特异度、阳性预测值和阴性预测值。结果110例疑似脊柱结核患者最终诊断为脊柱结核68例、非脊柱结核42例。TST 5、TST 15和T-SPOT.TB检测的敏感度、特异度、阳性预测值、阴性预测值分别为93%、33%、69%、74%，47%、83%、82%、49%和91%、90%、94%、86%。T-SPOT.TB检测敏感度优于TST 15，特异度优于TST 5，阳性预测值和阴性预测值均优于TST 5和TST 15（P＜0.05）。结论与TST比较，T-SPOT.TB检测诊断脊柱结核敏感度、特异度均较高，可用于脊柱结核的早期诊断。
目的：探討結覈感染T細胞斑點（T-SPOT.TB）檢測在脊柱結覈診斷中的應用價值。方法對2012年1月至2014年10月鄭州市骨科醫院收治的110例疑似脊柱結覈病例同時進行結覈菌素皮試試驗（TST）及T-SPOT.TB檢查，其中TST分彆採用紅腫硬結直徑≥5 mm和≥15 mm兩種標準，標記為TST 5和TST 15。以臨床診斷結果作為標準，對比分析上述檢測方法的敏感度、特異度、暘性預測值和陰性預測值。結果110例疑似脊柱結覈患者最終診斷為脊柱結覈68例、非脊柱結覈42例。TST 5、TST 15和T-SPOT.TB檢測的敏感度、特異度、暘性預測值、陰性預測值分彆為93%、33%、69%、74%，47%、83%、82%、49%和91%、90%、94%、86%。T-SPOT.TB檢測敏感度優于TST 15，特異度優于TST 5，暘性預測值和陰性預測值均優于TST 5和TST 15（P＜0.05）。結論與TST比較，T-SPOT.TB檢測診斷脊柱結覈敏感度、特異度均較高，可用于脊柱結覈的早期診斷。
목적：탐토결핵감염T세포반점（T-SPOT.TB）검측재척주결핵진단중적응용개치。방법대2012년1월지2014년10월정주시골과의원수치적110례의사척주결핵병례동시진행결핵균소피시시험（TST）급T-SPOT.TB검사，기중TST분별채용홍종경결직경≥5 mm화≥15 mm량충표준，표기위TST 5화TST 15。이림상진단결과작위표준，대비분석상술검측방법적민감도、특이도、양성예측치화음성예측치。결과110례의사척주결핵환자최종진단위척주결핵68례、비척주결핵42례。TST 5、TST 15화T-SPOT.TB검측적민감도、특이도、양성예측치、음성예측치분별위93%、33%、69%、74%，47%、83%、82%、49%화91%、90%、94%、86%。T-SPOT.TB검측민감도우우TST 15，특이도우우TST 5，양성예측치화음성예측치균우우TST 5화TST 15（P＜0.05）。결론여TST비교，T-SPOT.TB검측진단척주결핵민감도、특이도균교고，가용우척주결핵적조기진단。
Objective To investigate the diagnostic value of T-cell spot of tuberculosis (T-SPOT.TB) assay for patients with spinal tuberculosis. Methods From January 2012 to October 2014, a total of 110 suspected patients with spinal tuberculosis accepted both tuberculin skin test (TST) and T-SPOT.TB assay in Zhengzhou Orthopedics Hospital, in which TST using two standards of TST 5 (induration size ≥5 mm) and TST 15 (induration size ≥15 mm). According to the results of clinical diagnosis, the sensitivity, specificity, positive predict value and negative predict value of the two tests were evaluated and compared with each other. Results There were 68 patients diagnosed as spinal tuberculosis finally. The sensitivity, specificity, positive predict value and negative predict value of TST 5, TST 15 and T-SPOT.TB assay was 93%, 33%, 69%, 74%, and 47%, 83%, 82%, 49%, and 91%, 90%, 94%, 86% respectively. The sensitivity of T-SPOT.TB was higher than TST 15, and the specificity was higher than TST 5; The positive predict value and the negative predict value were all higher than TST 5 and TST 15 (P <0.05). Conclusion Compared with TST, T-SPOT.TB assay possesses more satisfactory sensitivity and specificity in the diagnosis of spinal tuberculosis, which could be used to help the early diagnosis of spinal tuberculosis.
