T-SPOT在儿童结核病诊断中的价值
发布时间：2018-05-16 12:19
本文选题：儿童 + 结核 ； 参考：《中国感染控制杂志》2017年11期
【摘要】：目的探讨T淋巴细胞酶联免疫斑点法(T-SPOT)在儿童结核病(TB)诊断中的应用价值。方法选取2015年3月—2016年5月某院收治并确诊的TB患儿43例作为结核组,随机选取同期在该院门诊及住院部排除结核感染的患儿及健康儿童50例作为对照组,分别对两组进行T-SPOTPPD结核抗体(MTB-Ab)及涂片抗酸染色等四种方法检测和对比分析,并对T-SPOT法在结核组不同感染部位、不同年龄段患者的阳性情况进行亚组分析。结果 T-SPOT在灵敏度和阴性预测值方面高于其余三种方法(P0.05),特异度也高于PPD法(P0.05);T-SPOT在肺内结核和肺外结核中检出的阳性率分别为88.9%和81.3%,差异无统计学意义(P0.05);在≤5岁和5岁儿童两组之间的检出率分别为70.6%和96.2%,差异有统计学意义(P0.05)。采用T-SPOT法和PPD法两种方法进行并联模式的结核检测时的灵敏度为95.3%,特异度为98.0%,相比于单一方法检测均有提高(P0.05)。结论 T-SPOT法在儿童TB检测方面相对于传统方法在灵敏度和特异度上均有优势,也适用于肺外结核的检测,可作为儿童结核实验室诊断的主要方法,但在5岁以下儿童存在不确定性,应合理联合PPD法检测,才能更好发挥在儿童TB诊断中的价值。
[Abstract]:Objective to evaluate the diagnostic value of T lymphocyte enzyme linked immunoblot assay (T-SPOT) in the diagnosis of children with tuberculosis (TB). Methods from March 2015 to May 2016, 43 children with TB were selected as tuberculosis group, 50 children who were excluded from tuberculosis infection in outpatient and inpatient department of the hospital and 50 healthy children were selected as control group. Four methods, MTB-Aband smear acid-fast staining, were detected and compared. The positive rate of T-SPOT method in different infection sites and age groups of tuberculosis patients was analyzed by subgroup analysis. Results the sensitivity and negative predictive value of T-SPOT were higher than those of the other three methods (P0.05A), and the specificity of T-SPOT was higher than that of PPD method. The positive rates of T-SPOT in pulmonary tuberculosis and extrapulmonary tuberculosis were 88.9% and 81.3%, respectively, and there was no significant difference between them in 鈮，
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