结核感染T细胞斑点试验在骨与关节结核诊断中的价值

发布时间：2018-04-05 21:44

本文选题：T细胞斑点试验　切入点：结核　出处：《临床骨科杂志》2016年04期

【摘要】：目的探讨结核感染T细胞斑点试验(T-SPOT TB)在临床诊断骨与关节结核的应用价值。方法收集154例疑似骨与关节结核患者外周抗凝血标本,依据细菌学检验、病理学结果及临床表现判定有无结核分枝杆菌感染;其中确诊骨与关节结核73例,非结核感染81例,分别进行T-SPOT TB和结核抗体(TB-Ab)检测,并分析T-SPOT TB在骨与关节结核诊断中的敏感度和特异度。结果 73例确诊骨与关节结核中,64例T-SPOT TB阳性;81例非结核中,72例T-SPOT TB阴性;T-SPOT TB检测敏感度为87.67%(64/73),TB-Ab为41.10%(30/73),T-SPOT TB诊断骨与关节结核的敏感度显著高于TB-Ab(P0.001);T-SPOT TB检测特异度为88.89%(72/81),TB-Ab为71.60%(58/81),T-SPOT TB特异度也高于TB-Ab(P=0.006)。在结核组中,涂阳与涂阴两组T-SPOT TB阳性检出率分别为95.45%(21/22)及86.49%(32/37),差异无统计学意义(P0.05)。在结核组中,病理诊断阳性率92.16%(47/51)与T-SPOT TB总阳性率87.67%(64/73)比较差异无统计学意义(P0.05)。结论 T-SPOT TB在诊断骨与关节结核中具有良好的敏感度和特异度,具有重要临床应用价值。
[Abstract]:Objective to evaluate the clinical value of T spot TBtest in the diagnosis of bone and joint tuberculosis.Methods Peripheral anticoagulant specimens were collected from 154 suspected bone and joint tuberculosis patients. According to bacteriological examination, pathological results and clinical manifestations, Mycobacterium tuberculosis infection was determined in 73 cases of bone and joint tuberculosis, 81 cases of non-tuberculosis infection.The sensitivity and specificity of T-SPOT TB and TB antibody TB-Abin in the diagnosis of bone and joint tuberculosis were analyzed.The specificity of T-spot TB was also higher than that of TB-AbP0. 006.In tuberculosis group, the positive rates of T-SPOT TB in smear positive group and negative smear group were 95.4545 / 22 and 86.49 / 32 / 37, respectively. The difference was not statistically significant (P 0.05).In tuberculosis group, the positive rate of pathological diagnosis was 92.16 / 51) and the total positive rate of T-SPOT TB was 87.67 / 64 / 73) there was no significant difference between them (P 0.05).Conclusion T-SPOT TB has good sensitivity and specificity in the diagnosis of bone and joint tuberculosis.
【作者单位】：安徽省肿瘤医院骨科;
【分类号】：R529.2

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