结核感染T细胞斑点试验在手、腕部腱鞘结核诊断中的应用评价

目的 探讨结核感染T细胞斑点试验(T-cell spot of Tuberculosis,T-SPOT.TB)在手、腕部腱鞘结核诊断中的临床应用价值.方法 通过对2012年1月至2018年1月我院收集64例怀疑手、腕部腱鞘结核临床资料进行回顾性分析,根据病理诊断及临床表现判断有无结核分枝杆菌感染;全部病例均经过T-SP...

Evaluation of the T-SPOT.TB test for diagnosis of Tuberculous tenosynovitis of the hand and wrist

To evaluate the clinical application of the T-SPOT.TB test in the diagnosis of Tuberculous tenosynovitis of the hand and wrist,we retrospectively analyzed the clinical information for 64 suspected cases of Tuberculous tenosynovitis of the hand and wrist treated in our hospital between January 2012 and January 2018.Pathological diagnosis and clinical manifestations were used for the diagnosis of tuberculosis infection.All patient samples were assayed with T-SPOT.TB,the colloidal gold method,interferon gamma release assays and serum tuberculosis antibody detection.All data statistical analyses were performed with Kappa and Chi-square tests.A series of 64 related cases were analyzed,among which 21 patients were diagnosed with Tuberculous tenosynovitis of the hand and wrist(tuberculous cases),and 43 patients were diagnosed with non-tuberculosis tenosynovitis of the hand and wrist(non-tuberculous cases).The T-SPOT.TB test revealed 20 cases positive for tuberculosis and 40 cases negative for tuberculosis,with 95.2%sensitivity and 93.0%specificity.The positive and negative predictive value of the test was 87.6%and 97.6%,respectively.In serum tuberculosis antibody tests with the colloidal gold method test,5 positive tuberculosis cases and 37 negative tuberculosis cases were found,with 23.8%sensitivity and 86.0%specificity;the positive and negative predictive value was 45.4%and 69.8%,respectively.Additionally,the Kappa values for the T-SPOT.TB test and colloidal gold method were 0.862 and 0.112,respectively,thus indicating that T-SPOT.TB showed better consistency,and higher sensitivity and positive and negative predictive value,than the colloidal gold method(P<0.05).T-SPOT.TB thus has good supplementary diagnostic value for tuberculous tenosynovitis of the hand and wrist.