结核感染T细胞斑点试验在小儿结核诊断中的应用研究

【】　目的　探讨结核感染T细胞斑点试验(tuberculosis infection of T-cell spot test T-SPOT.TB)在小儿结核诊断中的应用价值。 方法 回顾性分析2014年8月至2016年4月武汉大学人民医院收治的78例疑似小儿结核患者病例,收集患者年龄、性别、是否接种卡介苗、临床表现及诊断、结核菌素纯蛋白衍生物(purified protein derivative, PPD)试验及T-SPOT.TB检测结果。结合最终临床诊断,对比分析PPD与T-SPOT.TB检测在小儿结核诊断中的应用价值。 结果 78例疑似小儿结核患者分为确诊及临床诊断小儿结核组小儿结核组13例,排除小儿结核组65例。T-SPOT.TB和PPD检测的敏感度、特异度、阳性预测值、阴性预测值分别为84.6%、100.0%、100.0%、97.0%和69.2%、76.9%、37.5%、90.9%。T-SPOT.TB检测的敏感度、特异性均高于PPD,差异具有统计学意义(P<0.05)。结论 T-SPOT检测诊断小儿结核的敏感性、特异性均较高。T-SPOT检测可辅助诊断小儿结核,阴性结果有助于排除小儿结核。

Diagnostic performance of T-SPOT.TB assay in children with tuberculosis

Objective To evaluate the application value of T-SPOT.TB assay in the diagnosis of tuberculosis in children.Methods A total of 78 patients of children with suspected tuberculosis were enrolled in this retrospective study.Age,gender,imageology character,clinical manifestation and diagnosis,PPD and T-SPOT.TB testing result were collected.According to the results of clinical diagnosis,the diagnostic value of the two tests were evaluated and compared with each other.Results Thirteen patients had culture-confirmed or probable tuberculosis,and the remaining 65 patients did not have tuberculosis.The sensitivity,specificity,positive predictive value,and negative predictive value of PPD and T-SPOT.TB test were 84.6%,100.0%,100.0%,97.0% and 69.2%,76.9%,37.5%,90.9% respectively.The sensitivity and specificity of T-SPOT.TB assay were higher than PPD test (P<0.05).Conclusions Compared with PPD,T-SPOT.TB assay possesses more satisfactory sensitivity and specificity in the diagnosis of tuberculosis in children,which could provide useful support in diagnosing tuberculosis in children.And tuberculosis could be excluded based on a negative T-SPOT.TB assay.