[1]吴大鹏,韩博闻,万 广,等.结核感染T细胞斑点试验在脊柱结核辅助诊断中的应用价值[J].新乡医学院学报,2022,39(5):445-449.[doi:10.7683/xxyxyxb.2022.05.009]
 WU Dapeng,HAN Bowen,WAN Guang,et al.Application value of T cell spot test for tuberculosis infection in auxiliary diagnosis of spinal tuberculosis[J].Journal of Xinxiang Medical University,2022,39(5):445-449.[doi:10.7683/xxyxyxb.2022.05.009]
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结核感染T细胞斑点试验在脊柱结核辅助诊断中的应用价值
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
39
期数:
2022年5
页码:
445-449
栏目:
临床研究
出版日期:
2022-05-05

文章信息/Info

Title:
Application value of T cell spot test for tuberculosis infection in auxiliary diagnosis of spinal tuberculosis
作者:
吴大鹏韩博闻万 广赵恩典谢会彬宋 凯梁秋冬
(新乡医学院第一附属医院骨科,河南 卫辉 453100)
Author(s):
WU DapengHAN BowenWAN GuangZHAO EndianXIE HuibinSONG KaiLIANG Qiudong
(Department of Orthopaedics,the First Affiliated Hospital of Xinxiang Medical University,Weihui 453100,Henan Province,China)
关键词:
脊柱结核结核感染T细胞斑点试验辅助诊断
Keywords:
spinal tuberculosisT cell spot test for tuberculosis infectionauxiliary diagnosis
分类号:
R529.2
DOI:
10.7683/xxyxyxb.2022.05.009
文献标志码:
A
摘要:
目的 评估结核感染T细胞斑点(T-SPOT.TB)试验在脊柱结核辅助诊断中的应用价值。 方法 选择2018年5月至2020年3月新乡医学院第一附属医院收治的经影像学检查疑似脊柱结核患者106例为研究对象,根据脊柱结核临床综合诊断标准,最终确诊为脊柱结核69例和非脊柱结核37例;所有患者接受结核菌素皮肤试验(TST)(TST5、TST15)、结核抗体检测、病理学检查和T-SPOT.TB试验,比较上述检测方法对脊柱结核诊断的敏感度、特异度、阳性预测值、阴性预测值、检出率及与病理学检查结果的一致性。结果 TST5、TST15、结核抗体试验、病理学检查和T-SPOT.TB试验诊断脊柱结核的敏感度分别为63.77%(44/69)、52.17%(36/69)、57.97%(40/69)、86.95%(60/69)、88.41%(61/69),特异度分别为67.57%(25/37)、86.49%(32/37)、81.08%(30/37)、89.19%(33/37)、89.19%(33/37),阳性预测值分别为78.57%(44/56)、87.80%(36/41)、85.11%(40/47)、93.75%(60/64)、93.85%(61/65),阴性预测值分别为50.00%(25/50)、49.23%(32/65)、50.85%(30/59)、78.57%(33/42)、80.49%(33/41)。T-SPOT.TB试验诊断脊柱结核的敏感度显著高于TST5、TST15和结核抗体试验(χ2=11.510、21.687、16.285,P<0.05);T-SPOT.TB试验与病理学检查诊断脊柱结核的敏感度比较差异无统计学意义(χ2=0.067,P>0.05);T-SPOT.TB试验诊断脊柱结核的特异度显著高于TST5(χ2=5.103,P<0.05);T-SPOT.TB试验与TST15、结核抗体试验和病理学检查诊断脊柱结核的特异度比较差异无统计学意义(χ2=0.126、0.961、0.001,P>0.05)。T-SPOT.TB试验诊断脊柱结核的阳性预测值显著高于TST5(χ2=6.117,P<0.05);T-SPOT.TB试验与TST15、结核抗体试验和病理学检查诊断脊柱结核的阳性预测值比较差异无统计学意义(χ2=1.181、2.352、0.001,P>0.05)。T-SPOT.TB试验诊断脊柱结核的阴性预测值显著高于TST5、TST15和结核抗体试验(χ2=9.060、10.356、9.117,P<0.05),T-SPOT.TB试验与病理学检查诊断脊柱结核的阴性预测值比较差异无统计学意义(χ2=0.047,P>0.05)。T-SPOT.TB试验与TST5、TST15、结核抗体试验和病理学检查结果一致性检验的Kappa值分别为0.216、0.282、0.080、0.663;T-SPOT.TB试验与病理学检查结果具有高度的一致性。结论 T-SPOT.TB试验应用于脊柱结核的辅助诊断具有良好的敏感度、特异度、阳性预测值、阴性预测值和检出率,与病理学检查具有良好的一致性。
Abstract:
Objective To evaluate the application value of T-cell spot test for tuberculosis infection (T-SPOT.TB) in auxiliary diagnosis of spinal tuberculosis.Methods A total of 106 patients with suspected spinal tuberculosis admitted to the First Affiliated Hospital of Xinxiang Medical University from May 2018 to March 2020 were selected as the research subjects.According to the comprehensive clinical diagnostic criteria of spinal tuberculosis,69 cases were finally diagnosed as spinal tuberculosis,and 37 cases were finally diagnosed as non-spinal tuberculosis.All patients received tuberculin skin test (TST) (TST5,TST15),tuberculosis antibody test,pathological examination and T-SPOT.TB test.The sensitivity,specificity,positive predictive value,negative predictive value,detection rate and consistency of the above detection methods for the diagnosis of spinal tuberculosis were compared.Results The sensitivity of TST5,TST15,tuberculosis antibody test,pathological examination and T-SPOT.TB test for the diagnosis of spinal tuberculosis was 63.77% (44/69),52.17% (36/69),57.97% (40/69),86.95% (60/69) and 88.41% (61/69),respectively;the specificity was 67.57% (25/37),86.49% (32/37),81.08% (30 /37),89.19% (33/37) and 89.19% (33/37),respectively;and the positive predictive value was 78.57% (44/56),87.80% (36/41),85.11% (40/47),93.75%(60/64) and 93.85%(61/65),respectively;the negative predictive value was 50.00% (25/50),49.23% (32/65),50.85% (30/59),78.57% (33/42) and 80.49% (33/41),respectively.The sensitivity of T-SPOT.TB test in diagnosing spinal tuberculosis was significantly higher than that of TST5,TST15 and tuberculosis antibody test (χ2=11.510,21.687,16.285;P<0.05).There was no significant difference in the sensitivity of T-SPOT.TB test and pathological examination in the diagnosis of spinal tuberculosis (χ2=0.067,P>0.05).The specificity of T-SPOT.TB test for diagnosing spinal tuberculosis was significantly higher than that of TST5 (χ2=5.103,P<0.05).There was no significant difference in the specificity between T-SPOT.TB test,TST15,tuberculosis antibody test and pathological examination for diagnosing spinal tuberculosis (χ2=0.126,0.961,0.001;P>0.05).The positive predictive value of T-SPOT.TB test in the diagnosis of spinal tuberculosis was significantly higher than that of TST5 (χ2=6.117,P<0.05).There was no significant difference in the positive predictive value between T-SPOT.TB test,TST15,tuberculosis antibody test and pathological examination in the diagnosis of spinal tuberculosis (χ2=1.181,2.352,0.001;P>0.05).The negative predictive value between T-SPOT.TB test in the diagnosis of spinal tuberculosis was significantly higher than that of TST5,TST15 and tuberculosis antibody test (χ2=9.060,10.356,9.117;P<0.05).There was no significant difference in the negative predictive value between T-SPOT.TB test and pathological examination in the diagnosis of spinal tuberculosis (χ2=0.047,P>0.05).The consistency check showed the Kappa value of T-SPOT.TB test and TST5,TST15,tuberculosis antibody test and pathological examination was 0.216,0.282,0.080 and 0.663,respectively.The results of T-SPOT.TB test and pathological examination were highly consistent.Conclusion The T-SPOT.TB test has good sensitivity,specificity,positive predictive value,negative predictive value and detection rate in the early auxiliary diagnosis of spinal tuberculosis,and has good consistency with pathological examination.

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更新日期/Last Update: 2022-05-05