| 活动性结核病外周血结核感染T细胞斑点试验阴性病例的临床特征 |
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| 作者姓名： | 万荣 李光妹 马萌 赖明红 刘才 李明武 |
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| 作者单位： | 昆明市第三人民医院结核二科，云南 昆明 650041 |
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| 基金项目： | 昆明市科学技术局科研基金资助项目（2019-1-S-25318000001392） |
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| 摘 要： | 目的 分析活动性结核病外周血结核感染T细胞斑点试验(T-SPOT.TB)阴性病例的临床特征.方法 以2019年1～12月在昆明市第三人民医院结核二科住院的经痰检、体液或组织标本检测结核病原学阳性且T-SPOT.TB阴性和同期收治T-SPOT.TB阳性活动性结核病为研究对象,T-SPOT.TB阴性病例组83例,T-SPO...
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| 关 键 词： | 活动性 结核病 结核感染 T细胞斑点试验 阴性 |
| 收稿时间： | 2022-02-21 |
Clinical Features of Tuberculosis with Negative T Cell Spot Test in Peripheral Blood |
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| Affiliation: | Dept. of Tuberculosis，The 3rd People’s Hospital of Kunming，Kunming Yunnan 650041， China |
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| Abstract: | Objective To analyze the clinical features of active tuberculosis cases with negative T cell spot assay （T-SPOT.TB） in peripheral blood. Methods A total of 83 active tuberculosis patients admitted to the Second Department of Tuberculosis in Kunming Third People’ s Hospital from January to December 2019 who tested negative T-SPOT.TB were selected as the study subjects; another 82 active tuberculosis patients who tested positive T-SPOT.TB were selected as the control. The clinical characteristics of the two groups were compared, and the positive rates of several conventional experimental detection methods were compared. Results There was no difference in age and gender between the T-spot. TB negative group and the T-spot. TB positive group （P > 0.05）, however, there were more patients over 60 years old in the T-spot TB negative group （22.9%）, but there was no difference, in 2 groups （P > 0.05）. There was no difference in the comorbidity of the 2 groups, and diabetes was more common （ P > 0.05）. The incidence of extrapulmonary tuberculosis was about half in both groups; tuberculosis pleurisy was more common in the T-SPOT.TB negative group, and tracheal tuberculosis was more common in the positive group. Cellular immune related examination showed nearly 90% of patients have low cellular immune function. All cases were routinely tested for acid-fast bacilli smear, TB-DNA, XpertMtb/RIF and TB culture. In the 2 groups, the positive rate of XpertMtb/RIF was the highest （77.1% and 64.6%, respectively）, which was significantly higher than the other 3 detection methods. There was statistical difference （P < 0.001）. Conclusion Old age, complicating extrapulmonary tuberculosis, and low immune function may be the causes of T-SPOt-TB negative in active tuberculosis. XpertMtb/RIF test can be used for rapid early diagnosis of TB. |
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