Diagnostic value of T-SPOT for tuberculosis in children
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摘要: 目的:探讨外周血结核分枝杆菌(Mycobacterium tuberculosis,MTB)感染T细胞斑点试验(T-SPOT.TB)在儿童结核病诊断中的应用价值。方法:选取2015-08-2018-02在武汉市金银潭医院收治并确诊的70例结核病患儿为观察组,随机选取同期在儿童医院就诊的70例非结核病患儿为对照组。对入组患儿分别做T-SPOT.TB、结核分枝杆菌/利福平耐药基因检测(Xpert MTB/RIF)、MTB蛋白芯片、结核抗体(MTBAb)、荧光染色法和液体快速培养法检测,比较各项检测的应用价值。结果:观察组6种检测方法阳性率分别为58.57%、41.43%、30.00%、30.00%、12.86%、27.14%。T-SPOT.TB阳性率高于其他5种方法,差异有统计学意义(P<0.05)。T-SPOT.TB在肺内结核和肺外结核中检出的阳性率分别为63.41%和51.72%,差异无统计学意义(P>0.05),均高于其他方法。结论:T-SPOT.TB采用外周血标本容易留取,能显著提高灵敏度,有较高的特异度、阳性预测值、阴性预测值和诊断准确率,在肺内结核和肺外结核检测中均有较高的阳性率,有利于早期诊断和治疗并可防止漏诊,对儿童结核病的诊断具有重要的辅助诊断价值。Abstract: Objective:To invertigate the value of peripheral blood T-SPOT.TB in the diagnosis of tuberculosis in children.Method:A total of 70 children who were admitted to our hospital and confirmed with TB between August 2015 and February 2018 were selected as observation group,70 children who were excluded TB in a Children's hospital during the same period were as control group.Peripheral blood T-SPOT.TB,Xpert MTB/RIF,protein-chip of Mycobacterium tuberculosis(MTB),MTBAb,fluorescent staining and rapid liquid culture in the two groups were underwent detection to evaluate the clinical value.Result:Positive rates of six different methods in the observation group were 58.57%,41.43%,30.00%,30.00%,12.86% and 27.14%.The sensitivity of T-SPOT.TB was significantly higher than that of the other five methods,and the differences were statistically significant(P<0.05).Posititive rates of T-SPOT.TB in pulmonary tuberculosis and ertrapulmonary tuberculosis were 63.41% and 51.72% respectively,which different was not statistically significant(P>0.05),and both were higher than that of other methods.Conclusion:T-SPOT.TB is easy to use peripheral blood specimens,which can improve the sensitivity with a good specificity,positive predictive walue,negative predictive value and diagnostic accuracy,may help early diagnosis and treatment and prevent missed diagnosis,and have important auxiliary diagnostic value of TB among children.
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Key words:
- T-SPOT /
- child /
- tuberculosis /
- diagnosis /
- value
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