论文部分内容阅读
目的探讨结核感染T细胞斑点实验(T-SPOT.TB)在骨关节结核诊断中的价值,以期为临床提供参考。方法选取2015年4月至2016年4月收治的疑似骨关节结核患者114例,分别采用T-SPOT.TB和抗结核抗体检查进行诊断,比较两种方法的诊断价值。结果 114例患者中,共有90例确诊(均根据患者的临床表现、CT或MRI图像、结核病原学检查、组织病理学检查等结果综合评估确定)为骨关节结核,24例为非骨关节结核;T-SPOT.TB诊断骨关节结核的灵敏度为90.00%,特异度为79.17%,阳性预测值为94.19%,阴性预测值为67.86%,与最终诊断结果 Kappa值为0.652,一致性较好;抗结核抗体检查诊断骨关节结核的灵敏度为53.33%,特异度为70.83%,阳性预测值为87.27%,阴性预测值为28.81%,与最终诊断结果 Kappa值为0.157,一致性差。结论 T-SPOT.TB检查在骨关节结核中有较好的诊断价值,可辅助诊断骨关节结核。
Objective To investigate the value of T-SPOT.TB in diagnosis of tuberculosis of the bone and joint in order to provide a reference for clinic. Methods One hundred and fourteen patients with suspected bone-and-joint tuberculosis were selected from April 2015 to April 2016. T-SPOT.TB and anti-TB antibody were used for diagnosis respectively. The diagnostic value of the two methods were compared. Results Of the 114 patients, 90 cases were diagnosed (all according to the patient’s clinical manifestations, CT or MRI images, tuberculosis, histopathological examination and other results to determine the comprehensive evaluation) for the bone-joint tuberculosis, 24 cases of non-joint tuberculosis The sensitivity and specificity of T-SPOT.TB for the diagnosis of osteoarticular tuberculosis were 90.00%, 79.17%, 94.19%, 67.86%, respectively, which were consistent with the final diagnostic value of Kappa 0.652. The sensitivity and specificity of anti-TB antibody in diagnosing osteoarticular tuberculosis were 53.33%, 70.83%, 87.27%, 28.81%, respectively, and the Kappa value of final diagnosis was 0.157. Conclusion T-SPOT.TB examination in the diagnosis of osteoarticular tuberculosis has a good diagnosis, can help diagnose bone and joint tuberculosis.