酶联免疫斑点试验在骨关节结核诊断中的价值

目的研究酶联免疫斑点试验（ELISPOT）在骨关节结核临床诊断中的应用价值。方法对54例骨关节病患者进行ELISPOT试验，并进行斑点阅读与统计，判定骨关节结核阳性结果。结果54例患者中20例经手术病理诊断明确为骨关节结核，ELISPOT A抗原试验灵敏度80.00%，特异度91.18%，正确率87.04%，Kappa值0.72。 ELISPOT B抗原试验灵敏度80.00%，特异度97.06%，正确率90.74%，Kappa值0.80。A抗原ROC曲线下面积0.99，B抗原曲线下面积0.87，最佳临界值均为4.5。结论 ELISPOT是一种具有较高敏感性和特异性的检测结核感染的技术，可用于骨结核的辅助诊断。

Diagnosis value of enzyme-linked immunospot assay in bone and joint tuberculosis

Objective To study the diagnostic value of enzyme-linked immuno-spot assay（ELISPOT） in bone and joint tuberculosis. Methods A total of 54 patients with bones and joints diseases were underwent the enzyme-linked immuno-spot assay to detect fleck and to estimate the positive results of joint tuberculosis. Results In 54 patients , 20 cases were diagnosed as bone and joint tuberculosis by surgical pathology. The sensitivity, specificity, accuracy and Kappa value of ELISPOT antigen A test were 80.00%, 91.18%, 87.04% and 0.72 respectively. The sensitivity, specificity, accuracy and Kappa value of ELISPOT antigen B test were 80.00%, 97.06%, 90.74%and 0.80 respectively. The areas under of ROC of A and B antigen were 0.99 and 0.87 respectively and their cut off were 4.5. Conclusions The enzyme-linked immuno-spot method had a higher sensitivity and specificity for detecting tuberculosis infection technique which can be used for the auxiliary diagnosis of bone tuberculosis.