[1]邵吉宝a,王相栋a,夏 睿a,等.T-SPOT.TB,TB-Ab和TB-DNA在肺结核与非结核分枝杆菌肺病鉴别诊断中的价值研究[J].现代检验医学杂志,2018,33(04):104-106/111.[doi:10.3969/j.issn.1671-7414.2018.04.028]
　SHAO Ji-baoa,WANG Xiang-donga,XIA Ruia,et al.Value of T-SPOT.TB,TB-Ab and TB-DNA in Differential Diagnosis of Pulmonary Tuberculosis and Nontuberculous Mycobateria Pulmonary Disease[J].Journal of Modern Laboratory Medicine,2018,33(04):104-106/111.[doi:10.3969/j.issn.1671-7414.2018.04.028]
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T-SPOT.TB,TB-Ab和TB-DNA在肺结核与非结核分枝杆菌肺病鉴别诊断中的价值研究()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第33卷
期数:
2018年04期
页码:
104-106/111
栏目:
论著
出版日期:
2018-08-30

文章信息/Info

Title:
Value of T-SPOT.TB,TB-Ab and TB-DNA in Differential Diagnosis of Pulmonary Tuberculosis and Nontuberculous Mycobateria Pulmonary Disease
文章编号:
1671-7414(2018)04-104-04
作者:
邵吉宝a; 王相栋a; 夏 睿a; 邵 燕a; 徐春华b; 严 虹a
东南大学医学院附属南京市胸科医院a.检验科; b.呼吸内科,南京210029
Author(s):
SHAO Ji-baoa; WANG Xiang-donga; XIA Ruia; SHAOYana; XU Chun-huab; YAN Honga
a.Department of Laboratory Medicine; b.Department of Respiratory Medicine, Nanjing Chest Hospital,Medical School of Southeast University,Nanjing 210029,China
关键词:
肺结核;  非结核分枝杆菌肺病;  结核感染T细胞斑点试验;  结核抗体;  结核菌脱氧核糖核酸
分类号:
R378.91; R446.5
DOI:
10.3969/j.issn.1671-7414.2018.04.028
文献标志码:
A
摘要:
目的 探讨结核感染T淋巴细胞酶联免疫斑点试验(T-SPOT.TB),结核抗体(TB-Ab)和结核分枝杆菌脱氧核糖核酸(TB-DNA)在肺结核与非结核分枝杆菌肺病鉴别诊断中的价值。方法 回顾南京市胸科医院2013年3月～2017年4月收治的肺结核病人140例,非结核分枝杆菌肺病患者39例。两组患者均抽血做T-SPOT.TB,TB-Ab(胶体金法和蛋白芯片法)检测,培养阳性的标本同时做TB-DNA检测。统计四种方法的敏感度、特异度、阳性预测值、阴性预测值、假阳性率、假阴性率、阴性似然比、阳性似然比、诊断符合率和约登指数。结果 T-SPOT.TB敏感度、诊断符合率显著高于TB-Ab和TB-DNA(χ2=6.91～87.46,P<0.01)。T-SPOT.TB特异度显著高于TB-Ab(χ2=13.18～24.98,P<0.01),而与TB-DNA差异无统计学意义(Fisher's Exact Test,P=0.62>0.05)。结论 T-SPOT.TB检测在肺结核与非结核分枝杆菌肺病鉴别诊断中有很高的敏感度、特异度和诊断符合率,对两种疾病的鉴别诊断有很大价值。
Abstract:
Abstract:Objective To identify and distinguish pulmonarytuberculous(PJB)mycobacteria infections or non-tuberculous mycobacteria(NTM)pulmonary infections in a fast and accurate way,and evaluated sensitivity,specificity and diagnostic efficiency of T-SPOT.TB,TB-Ab(both colloidal gold method and protein chip method)and TB-DNA.Methods 140 pulmonary tuberculosis cases and 39 NTM pulmonary disease cases from March 2013 to April 2017 in Nanjing Chest Hospital were collected.All patients' bloodsamples were obtained and tested by T-SPOT.TB,TB-Ab.For cases with culturepositive result,tested their BALF or sputum by TB-DNA assay.The sensitivity,specificity,positive predictive values,negative predictive values,false-positive rates,false-negative rates,negative likelihood ratios,positive likelihood ratios,diagnostic accordance rates and Youden's index of these four methods in diagnosis of lung tuberculosis and NTM pulmonary disease were calculated.Results The sensitivity and diagnostic efficiency of T-SPOT.TB were significantly higher than TB-Ab and TB-DNA(χ2=6.91～87.46,P<0.05).The specificity of T-SPOT.TB were significantly higher than TB-Ab(χ2=13.18～24.98,P<0.01),but there was no significant differencein specificity between T-SPOT.TB and TB-DNA(Fisher's Exact Test,P=0.62>0.05).Conclusion T-SPOT.TB assay showed relativelyhigher sensitivity and specificity in diagnosis of PTB and NTM pulmonary diseaseand may provide valuable information in differential diagnosis.

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备注/Memo

备注/Memo:
作者简介:邵吉宝(1983-),男,在职硕士研究生,主管技师,研究方向:肺结核的实验室诊断,E-mail:979202335@qq.com。 通讯作者:严 虹,博士,副主任技师。
更新日期/Last Update: 2018-08-16