酶联免疫斑点技术在老年脊柱结核感染辅助诊断中的应用价值

【目的】评价酶联免疫斑点技术（ELISPOT ）在老年脊柱结核感染辅助诊断中的应用价值。【方法】选取2013年1月至2015年1月本院脊柱外科收治的疑似脊柱结核的老年患者56例，比较 ELISPOT试验、结核菌素（PPD）皮肤试验、血清抗结核抗体检测方法在老年脊柱结核感染辅助诊断中的敏感性、特异性、阳性预测值和阴性预测值。【结果】ELISPOT 试验在脊柱结核诊断中的敏感性、特异性、阳性预测值和阴性预测值分别为77．14％，85．71％，90．00％，69．23％；PPD 皮肤试验的敏感性、特异性、阳性预测值和阴性预测值分别为37．14％，71．43％，68．42％，40．54％；血清抗结核抗体试验的敏感性、特异性、阳性预测值和阴性预测值分别为48．57％，61．90％，68．00％，61．90％。在老年脊柱结核患者中，ELISPOT 试验的敏感性、特异性、阳性预测值均显著高于 PPD 皮肤试验和血清抗结核抗体试验。【结论】ELISPOT 法应用于老年脊柱结核诊断有良好的敏感性和特异性，可作为脊柱结核感染辅助诊断的有效方法。

Diagnostic Value of Enzyme-linked Immunospot Assay for Spinal Tuberculosis in the Elderly

Objective]To evaluate the diagnostic value of enzyme‐linked immunospot (ELISPOT ) assay in detecting spinal tuberculosis (STB) in the elderly .[Methods] Fifty‐six cases of suspected STB patients from January 2013 to January 2015 were recruited into the Department of Spinal Surgery of Hunan Provincial Hos‐pital .All cases were tested using the ELISPOT detection method ,PPD skin test ,and serum TB antibody de‐tection .The sensitivity ,specificity ,positive ,and negative predictive rates were compared and analyzed among the three detection methods .[Results] Among the 56 patients ,the overall sensitivity ,specificity ,positive pre‐dictive value ,and negative predictive value was 77 .14% ,85 .71% ,90 .00% ,and 69 .23% using the ELISPOT method ,respectively ;37 .14% ,71 .43% ,68 .42% ,and 40 .54% using the PPD skin test ; and 48 .57% , 61 .90% ,68 .00% ,and 41 .93% in the serum TB antibody test .The sensitivity ,specificity ,positive predictive value ,and negative predictive value of ELISPOT was significantly higher than those of the PPD skin test and antibody detection test .[Conclusion] The ELISPOT assay detection method is an effective technique for accu‐rate diagnosis of spinal TB in the elderly .