目的探讨结核感染T细胞斑点试验(T SPOT-TB)对老年不典型肺结核的诊断意义。方法选择87例老年不典型肺结核患者以及同期住院的排除结核病诊断的29例老年患者,分别取外周血进行T SPOT-TB检测及血结核抗体检测,实验结果进行比较。结果对于老年患者取外周血进行T SPOTTB试验,结核病组阳性率59.77%,对照组阳性率13.79%,经统计学分析差异有统计学意义(P<0.01);外周血结核抗体结核组阳性率52.87%,对照组阳性率37.93%,经统计学分析差异无统计学意义(P>0.05)。结核病组T SPOT-TB与血结核抗体阳性率比较,经统计学比较差异无统计学意义(P>0.05);但对照组T SPOT-TB与血结核抗体阳性率经统计学比较差异有统计学意义(P<0.05)。结论 T细胞斑点试验(T SPOT-TB)对于老年不典型肺结核是一种有效的辅助检查方法 ,其特异性优于血结核抗体检测。 Objective To investigate the diagnostic value of T-SPOT-TB test in elderly patients with atypical pulmonary tuberculosis. Methods Eighty-seven elderly patients with atypical pulmonary tuberculosis and 29 elderly patients with tuberculosis who were diagnosed with tuberculosis during the same period of hospitalization were enrolled in the study. T-SPOT-TB and anti-TB antibody were detected respectively in peripheral blood and the results were compared. Results T SPOTTB test was performed on peripheral blood of elderly patients. The positive rate was 59.77% in the tuberculosis group and 13.79% in the control group, and the difference was statistically significant (P <0.01). The positive rate of TB tuberculosis in the peripheral blood was 52.87 %, The positive rate of 37.93% in the control group, the statistical analysis showed no significant difference (P> 0.05). There was no significant difference between T SPOT-TB and anti-TB antibody positive rate in TB group (P> 0.05), but there was statistical difference between T SPOT-TB and TB antibody in control group Significance (P <0.05). Conclusion T-SPOT-TB is an effective method for the diagnosis of elderly patients with atypical pulmonary tuberculosis. Its specificity is better than that of blood antibody.