T细胞斑点试验在肠结核与克罗恩病鉴别诊断中的价值

发布时间：2018-06-25 22:42

本文选题：结核杆菌T细胞斑点试验 + 肠结核　；参考：《河南医学研究》2013年01期

【摘要】：目的:探讨结核杆菌T细胞斑点试验(T-spot.TB)在肠结核(Intestinal tuberculosis,ITB)与克罗恩病(Crohn’s disease,CD)鉴别诊断中的价值。方法:选取2010年2月至2012年5月郑州大学第一附属医院就诊并确诊的CD和ITB患者,登记患者临床资料,并对其进行T-spot.TB检测。结果:①临床症状腹泻在CD中的发生率显著高于ITB(CD:64.3%,ITB:33.3%,χ2=5.269,P0.05)。②实验室指标T-spot.TB在ITB中的阳性率显著高于CD(ITB:92.0%,CD:7.7%,χ2=36.250,P0.001),其敏感度和阳性预测值均为92.0%(23/25),特异度和阴性预测值均为92.3%(24/26)。③内镜及病理环行溃疡及回盲部受累在ITB中多见(ITB:17.6%,CD:0,P0.05和ITB:64.7%,CD:30.8%,P0.05)。淋巴细胞聚集在CD中多见(CD:84.6%,ITB:35.0%,P0.005),而肉芽肿形成在ITB中多见(ITB:55.0%,CD:11.5%,P0.005)。结论:T-spot.TB对两者鉴别有重要的意义,ITB和CD鉴别需要结合多方面综合判断。
[Abstract]:Objective: to investigate the value of T-spot test (T-spot.TB) in the differential diagnosis of intestinal tuberculosis (ITB) and Crohn's disease (CD). Methods: patients with CD and ITB were selected from the first affiliated Hospital of Zhengzhou University from February 2010 to May 2012. The clinical data were registered and T-spot.TB was detected. Results the incidence of clinical symptomatic diarrhea in CD was significantly higher than that in ITB (CD: 64.3 and ITB: 33.3, 蠂 2 / 5.269 P 0.05) .2 the positive rate of T-spot.TB in ITB was significantly higher than that in CD (ITB: 92.0% CD7.7, 蠂 236.250 P0.001). Its sensitivity and positive predictive value were both 92.0% (23 / 25), specificity and negative predictive value were 92.3% (24 / 26) and 92.0% (24 / 26), respectively. Pathological circular ulcers and ileocecal lesions were more common in ITB (ITB: 17.6m CD10: 0 and ITB: 64.7v CD30.8g P 0.05). Lymphocyte aggregation was more common in CD (CD: 84.6) than in ITB: 35.0 (P0.005), while granuloma was found in ITB (ITB: 55.0). Conclusion: t-spot. TB is of great significance in the identification of both. The identification of ITB and CD should be combined with comprehensive judgment in many aspects.
【作者单位】：郑州大学第一附属医院消化内科;河南省人民医院消化内科;
【分类号】：R524;R574

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