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目的评价γ干扰素体外释放试验[结核感染T细胞检测试剂盒(T-SPOT.TB)]在脊柱结核诊断中的意义。方法采用酶联免疫斑点试验检测32例脊柱结核患者(A组)、43例非脊柱结核患者(B组)和22例健康志愿者(C组)外周血中γ干扰素释放水平,同时与血清抗结核抗体、结核菌素试验(PPD)结果进行比较。结果 A组T-SPOT.TB的阳性诊断率高于B组和C组(P<0.01);A组中T-SPOT.TB的阳性率、敏感性和特异性均高于PPD及抗结核抗体(P<0.01);而B组T-SPOT.TB、PPD及抗结核抗体间的阳性率、敏感性和特异性差异均无统计学意义(P>0.05)。结论γ干扰素体外释放试验在脊柱结核诊断中具有较好的敏感性和特异性,可以用于脊柱结核的辅助诊断和鉴别诊断。
Objective To evaluate the in vitro release of interferon gamma (T-SPOT.TB) in the diagnosis of spinal tuberculosis. Methods The levels of IFN-γ in peripheral blood of 32 patients with spinal tuberculosis (group A), 43 patients with non-spinal tuberculosis (group B) and 22 healthy volunteers (group C) were detected by enzyme-linked immunospot assay. Anti-TB antibody, tuberculin test (PPD) results were compared. Results The positive rate of T-SPOT.TB in group A was higher than that in group B and C (P <0.01). The positive rate, sensitivity and specificity of T-SPOT.TB in group A were higher than those of PPD and anti-TB antibody (P <0.01). There was no significant difference in the positive rate, sensitivity and specificity between T-SPOT.TB, PPD and anti-TB antibody in group B (P> 0.05). Conclusion Gamma interferon in vitro release test has good sensitivity and specificity in the diagnosis of spinal tuberculosis and can be used for the diagnosis and differential diagnosis of spinal tuberculosis.