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目的探讨结核感染T细胞免疫斑点试验的反应强度与活动性结核病的关系。方法选取2012年6月1日至2014年12月31日期间在重庆医科大学附属第一医院呼吸科342例的住院患者,所有住院患者均进行了结核感染T细胞斑点试验(T-SPOT.TB)。分析T-SPOT.TB对结核病诊断的敏感性、特异性、阳性预测值、阴性预测值;同时比较在活动性肺内结核病组、活动性肺外结核病组及陈旧性结核病组的T-SPOT.TB的免疫强度。结果 T-SPOT.TB检测结核病的敏感性、特异性、阳性预测值、阴性预测值分别为:87.67%,79.19%,64.00%,93.84%。在活动性肺内结核病组中T-SPOT.TB免疫斑点数为抗原A(10,36),抗原B(11,50),在活动性肺外结核病组中为抗原A(15,50),抗原B(15,40);在陈旧性结核病组中为抗原A(6,20),抗原B(6,30)。比较活动性肺内结核病组、肺外结核病组及陈旧性结核病组T-SPOT.TB的免疫斑点数,发现活动性肺内结核病组与活动性肺外结核病组免疫强度强于陈旧性结核病组(H_A=0.015,H_B=0.012,P<0.05;H_A=0.006,H_B=0.006,P<0.05)。结论 T-SPOT.TB对结核病的诊断有较高的灵敏度和特异性,T-SPOT.TB阴性时可有效的排除结核分枝杆菌的感染,阳性时有利于辅助诊断活动性结核病。
Objective To investigate the relationship between the reaction intensity of tuberculosis infected T cell immunoblot test and active tuberculosis. Methods Inpatients with 342 cases of respiratory department in the First Affiliated Hospital of Chongqing Medical University from June 1, 2012 to December 31, 2014 were enrolled. T-SPOT.TB ). The sensitivity, specificity, positive predictive value and negative predictive value of T-SPOT.TB in the diagnosis of tuberculosis were analyzed. T-SPOT in active tuberculosis, active extra-tuberculosis and chronic tuberculosis were also compared. TB immune intensity. Results The sensitivity, specificity, positive predictive value and negative predictive value of T-SPOT.TB in detecting tuberculosis were 87.67%, 79.19%, 64.00% and 93.84% respectively. The number of T-SPOT.TB immunopotentials in the active pulmonary TB group was antigen A (10,36), antigen B (11,50), antigen A (15,50) in the active extrapulmonary TB group, Antigen B (15, 40); Antigen A (6, 20), Antigen B (6, 30) in the old TB group. Compared with those of T-SPOT.TB in active TB group, extra-pulmonary TB group and old TB group, we found that the immune intensity of active TB group and active extra-pulmonary TB group was stronger than that of old TB group H_A = 0.015, H_B = 0.012, P <0.05; H_A = 0.006, H_B = 0.006, P <0.05). Conclusion T-SPOT.TB has high sensitivity and specificity for the diagnosis of tuberculosis. When T-SPOT.TB is negative, it can effectively eliminate the infection of M. tuberculosis. When positive, it is helpful to diagnose active tuberculosis.