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目的探讨结核感染T细胞斑点试验在结核病患者诊断中的价值。方法对2012年4月至2013年4月沈阳市胸科医院收治的结核病疑似患者100例的临床资料进行回顾性分析。根据诊断情况将患者分为肺结核组、肺外结核组、非结核病组,记录各组患者抗结核治疗前T-SOPT.TB和TST试验检测结果,比较结核病患者抗结核治疗前后抗原A和抗原B特异性斑点数的变化。结果肺结核组T-SOPT.TB试验敏感度、特异度、阴性似然比、阳性似然比分别为86.96%、95.65%、0.007、28.396,TST试验敏感度、特异度、阴性似然比、阳性似然比分别为69.57%、65.22%、0.371、5.438;肺外结核组T-SOPT.TB试验敏感度、特异度、阴性似然比、阳性似然比分别为83.78%、91.89%、0.009、24.482,TST试验敏感度、特异度、阴性似然比、阳性似然比分别为67.57%、64.86%、0.194、3.128;非结核病T-SOPT.TB试验敏感度、特异度、阴性似然比、阳性似然比分别为7.50%、15.00%、0.011、26.714,TST试验敏感度、特异度、阴性似然比、阳性似然比分别为5.00%、12.50%、0.245、4.379。60例结核病患者抗结核治疗前抗原A特异性斑点和抗原B特异性斑点分别为98、49,抗结核治疗后抗原A特异性斑点和抗原B特异性斑点分别为46、18。抗结核治疗前后患者T细胞斑点试验结果比较,差异有统计学意义(P<0.05)。结论 T-SOPT.TB在诊断结核病患者中有较好的临床应用价值,敏感度和特异度较高。
Objective To investigate the value of T cell spot test in tuberculosis in the diagnosis of tuberculosis patients. Methods The clinical data of 100 cases of suspected tuberculosis admitted to Shenyang Chest Hospital from April 2012 to April 2013 were analyzed retrospectively. Patients were divided into tuberculosis group, extrapulmonary tuberculosis group and non-tuberculosis group according to the diagnosis, and the results of T-SOPT.TB and TST before TB treatment were recorded in each group. The levels of antigen A and antigen B before and after TB treatment were compared Changes in the number of specific spots. Results The sensitivity, specificity, negative likelihood ratio and positive likelihood ratios of T-SOPT.TB test in tuberculosis group were 86.96%, 95.65%, 0.007,28.396, respectively. The TST test sensitivity, specificity, negative likelihood ratio, positive The likelihood ratios were 69.57%, 65.22%, 0.371 and 5.438, respectively. The sensitivity, specificity, negative likelihood ratios and positive likelihood ratios of T-SOPT.TB in extra-pulmonary tuberculosis group were 83.78%, 91.89%, 0.009, The sensitivity, specificity, negative likelihood ratio (TCR) of T-SOPT.TB test in non-tuberculosis patients were 67.57%, 64.86%, 0.194, 3.128, respectively. The positive likelihood ratios were 7.50%, 15.00%, 0.011,26.714, respectively. The sensitivity, specificity, negative likelihood ratio and positive likelihood ratio of TST were 5.00%, 12.50%, 0.245 and 4.379.60 respectively Antigen A specific spots and antigen B specific spots before TB treatment were 98 and 49, respectively, and anti-TB specific antigens A and B specific spots were 46 and 18, respectively. Before and after anti-TB treatment of patients with T cell spot test results, the difference was statistically significant (P <0.05). Conclusion T-SOPT.TB in the diagnosis of patients with tuberculosis has a better clinical value, high sensitivity and specificity.