摘要:
目的:分析结核T细胞酶联免疫斑点试验(T-STOP.TB)对结核病的诊断及临床应用价值.方法:收集结核病患者160例,非结核病患者46例.利用酶联免疫斑点试验检测经结核特异性抗原(ESAT-6/CFP-10)刺激并分泌 γ-干扰素的结核致敏T淋巴细胞的数量 、涂片抗酸染色以及检测红细胞沉降率.结果:T-STOP.TB敏感度91.3%,特异度95.7%,阳性预测值98.6%,阴性预测值75.9%,均高于红细胞沉降率,且差异具有统计学意义(P<0.05);T-STOP.TB敏感度及阴性预测值高于涂片抗酸染色,差异具有统计学意义(P<0.05);T-STOP.TB特异度及阳性预测值与涂片抗酸染色相当,差异没有统计学意义(P=0.495,P=1.0);结核组T-SPOT.TB实验两种抗原阳性斑点数目均高于对照组,且差异具有统计学意义(Z=-14.258,Z=-13.620,P=0.00);ESAT-6抗原的斑点数cut-off值取17.5时,诊断结核的灵敏度和特异度分别可达到81.9%和98.7%;CFP-10抗原的斑点数cut-off值取19.0时,诊断结核的灵敏度和特异度分别可达到76.9% 和98.7%.结论:T-STOP.TB是灵敏度高 、特异性好的方法,可用于检测患者是否存在结核感染的辅助诊断.%Objective :Analysis of TB T cell enzyme-linked immune spot test (T - STOP .TB) for the diagno-sis of tuberculosis and the value of clinical application .Methods :Collected 160 cases of patients with tuberculosis ,46 cases of patients with tuberculosis .Using enzyme-linked immune spot test specific antigen by tuberculosis (ESAT to 6 / CFP10) stimulate secretion and r - the number of T lymphocyte sensitization to TB interferon ,sputum smear and acid-fast stain detection method of erythrocyte sedimentation rate .Results :The sensitivity of T-STOP .TB was 91 .3% ,the specificity was 95 .7% ,the positive predictive value was 98 .6% ,and the negative predictive value was 75 .9% ,which was higher than the erythrocyte sedimentation rate ,and the difference was statistically significant (P< 0 .05) .The sensitivity and negative predictive value of T-STOP .TB were higher than that of the acid-fast stain , and the difference was statistically significant (P< 0 .05) .The specificity and positive predictive value of T -STOP . TB were lower than the acid-fast stain ,but the difference was not statistically significant .The number of two kinds of antigen positive spots in the T-SPOT .TB test of tuberculosis group was higher than that of the control group ,and the difference was statistically significant (Z = - 14 .258 ,Z = - 13 .620 ,P= 0 .00) .With the cut-off value of the spot number of ESAT-6 antigen was 17 .5 ,the sensitivity and specificity of the diagnosis of tuberculosis can reach 81 .9%and 98 .7% .And with the cut-off value of the ESAT-6 antigen was 19 .0 ,the sensitivity and specificity of the diag-nosis of tuberculosis was 76 .9% and 98 .7% .Conclusion :T - STOP TB is a high specificity of detection sensitivity patient tuberculosis method ,can be used for the auxiliary diagnosis of tuberculosis .