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目的 :探讨T-SPOT.TB(结核感染T细胞酶联免疫斑点试验)在肺外结核诊断应用价值。方法 :收集在我院就诊肺外结核患者84例作为研究对象,同时选取非结核病患者20例作为对照,比较不同患者中T-SPOT.TB检测阳性率和ESAT-6和CFP-10的SCF数量的差异;比较T-SPOT.TB、TB-Ab和ESR检查诊断肺外结核的效能比较。结果 :肺外结核T-SPOT.TB检测阳性率(85.71%)明显高于非结核疾病组(10.0%),且差异具有统计学意义。肺外结核组ESAT-6和CFP-10的SCF数量分别为39(0-180)和27(0-125)显著高于非结核疾病组的SCF数量为6(0-35)和5(0-27),且差异具有统计学意义。T-SPOT.TB诊断肺外结核的灵敏度85.71%、特异度90.0%、准确率86.54%;TB-Ab诊断肺外结核的灵敏度67.86%、特异度70.0%、准确率68.27%;ESR诊断肺外结核的灵敏度54.76%、特异度60.0%、准确率55.77%;T-SPOT.TB诊断肺外结核的诊断效能优于TB-Ab和ESR。结论 :T-SPOT.TB在肺外结核中的阳性率高于非结核患者,T-SPOT.TB诊断肺外结核有较好的灵敏度和特异度。
Objective: To investigate the diagnostic value of T-SPOT.TB (tuberculosis infected T cell enzyme-linked immunospot assay) in the diagnosis of extrapulmonary tuberculosis. Methods: Totally 84 patients with extrapulmonary tuberculosis who were treated in our hospital were selected as research objects. Twenty patients with non-tuberculosis were selected as control. The positive rate of T-SPOT.TB and SCF of ESAT-6 and CFP-10 in different patients were compared ; Comparison of the efficacy of T-SPOT.TB, TB-Ab and ESR in the diagnosis of extrapulmonary tuberculosis. Results: The positive rate of T-SPOT.TB in pulmonary tuberculosis (85.71%) was significantly higher than that in non-tuberculosis group (10.0%), and the difference was statistically significant. The SCF numbers in extra-pulmonary tuberculosis ESAT-6 and CFP-10 were 39 (0-180) and 27 (0-125) respectively, significantly higher than those in non-tuberculosis group (6 (0-35) and 5 -27), and the difference was statistically significant. The sensitivity and specificity of T-SPOT.TB in diagnosing extra-pulmonary tuberculosis were 85.71%, 90.0% and 86.54%, respectively. The sensitivity and specificity of TB-Ab for extra-pulmonary tuberculosis were 67.86%, 70.0% and 68.27% The sensitivity of TB was 54.76%, the specificity was 60.0% and the accuracy was 55.77%. The diagnostic efficiency of T-SPOT.TB in diagnosis of extrapulmonary tuberculosis was better than that of TB-Ab and ESR. Conclusion: The positive rate of T-SPOT.TB in extrapulmonary tuberculosis is higher than that in non-tuberculosis patients. The sensitivity and specificity of T-SPOT.TB for diagnosis of extrapulmonary tuberculosis are good.