血T-SPOT.TB联合肺泡灌洗液TbDNA检测对诊断肺结核的应用价值

目的分析血T-SPOT.TB联合肺泡灌洗液(BALF)Tb DNA检测对肺结核诊断的价值。方法选择2013.3~11月86例疑似肺结核患者,经确诊后分为肺结核组46例、肺炎组40例,均行T-SPOT.TB、BALF-Tb DNA、BALF涂片、痰涂片、PPD、结核抗体检测,对各检测结果进行对比,并行T-SPOT.TB与BALFTb DNA联合检测与单用检测、涂片法、PPD、结核抗体对比分析。结果血T-SPOT.TB、BALF-Tb DNA敏感性分别为84.8%、80.4%,特异性分别为80.0%、77.5%,两者联合检测敏感性为100.0%,阳性预测值为97.1%,阴性预测值为100.0%,与单用检测对比,差异有统计学意义(P0.05),与涂片法、PPD、结核抗体对比,存在显著差异(P0.01)。结论血T-SPOT.TB与BALF-Tb DNA联合检测提高了肺结核的诊断阳性率,弥补对方不足,减少肺结核的漏诊、误诊,是一个有前途的检测方法。

Application value of the detection of blood T-SPOT. TB combined with bronchoalveolar lavage fluid (BALF) ;TbDNA in the diagnosis of tuberculosis

Objective To analyze the value of pulmonary tuberculosis diagnosis by detecting blood T-SPOT. TB combined with bronchoalveolar lavage fluid （ BALF） TbDNA. Methods 86 suspected pulmonary tubercu-losis patients were confirmed and then divided into two groups. The group A had 46 cases of pulmonary tuberculosis, and the group B had 40 cases of pneumonia. The two groups were given blood T-SPOT. TB, BALF-TbDNA, BALF smear, sputum smear, PPD and tuberculosis antibody. Results The sensitivity of blood T-SPOT. TB and BALF-TbDNA was respectively 84. 8% and 80. 4%, and the specificity was respectively 80. 0% and 77. 5%. The sensitivity, positive predictive value, and negative predictive value of blood T-SPOT. TB combined with BALF TbDNA test was＆amp;nbsp;respectively 100%, 97. 1%, and 100% （ P〈0. 05 ） . Conclusion The detection of blood T-SPOT. TB combined with BALF TbDNA can improve the positive rate of tuberculosis diagnosis.