38kD-lgG和TSPOT-TB联合检测在结核病诊断中的应用

摘要

ObjectiveTo evaluate the application value of tuberculosis antibody and enzyme linked immune-spot assay used for Clinical diagnosis of tuberculosis.MethodsThe two methods were used individually and in combination respectively to 72 active tuberculosis patients and 42 non-tuberculosis in control group.ResultsFor smear positive TB,the sensitivity of TSPOT-TB(90.63%)was significantly higher than that of 38kD-lgG test(78.13%)(P<0.05),and was epual to the sensitivity of 96.88% of combined detection;for bacteriological negative TB, the sensitivity of combined detection(95%)was significantly higher than that of 85% and 77.50% by TSPOT-TB and 38kD-lgG(P<0.05);42 non-tuberculosis control,the sensitivity were 78.57% and 90.48% respectively,the sensitivity of combined detection was 66.67%;the detection sensitivity of extra pulmonary TB by TSPOT-TB were significantly higher than those of 38kD-lgG,and was equal to the sensitivity of combined detection.ConclusionTSPOT-TB test in smear positive patients and tuberculous pleurisy and meningitis in patients with higher sensitivity,in the non tuberculosis population specificity is good;in the differential diagnosis of smear negative patients,38kD-lgG and TSPOT-TB test and application will improve the greater sensitivity.%目的：探讨抗结核抗体（38kD-lgG）和结核感染T细胞斑点试验（TSPOT-TB）联合检测在结核病临床诊断中的价值。方法采用上述两种方法单项或联合检测疑结核患者114例，其中结核患者72例，非结核患者42例，对检测结果进行比较分析。结果 TSPOT-TB及38kD-IgG试验单项检测结核菌阳性（菌阳）结核患者的敏感性分别为90.63%和78.13%，二者差异有统计学意义（P<0.05），联合检测敏感性为96.88%。TSPOT-TB及38kD-IgG试验单项检测结核菌阴性（菌阴）结核患者的敏感性分别为80.00%和77.50%，联合检测敏感性为95.00%，联合检测与两种单项检测比较，差异有统计学意义（P<0.05）。对照组中，TSPOT-TB及38kD-IgG试验特异性分别为90.48%和78.57%，联合检测特异性为66.67%。TSPOT-TB试验对3种肺外结核的检测敏感性显著高于38kD-IgG试验（P<0.05）。结论对于菌阳患者，TSPOT-TB试验敏感性较高。对于菌阴患者，联合检测敏感性较高。38kD-lgG和TSPOT-TB联合检测可提高结核病的诊断敏感性。