| 引用本文： |
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邹丹凤,肖和平,尹洪云.结核感染T细胞斑点试验在HIV/AIDS 合并结核病诊断中的应用[J].同济大学学报（医学版）,2015,36(5):74-78. [点击复制]
- ZOU Dan-feng,XIAO He-ping,YIN Hong-yun.Clinical application of T-SPOT.TB in diagnosis of tuberculosis in patients with HIV infection[J].同济大学学报（医学版）,2015,36(5):74-78. [点击复制]
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| 摘要: |
| 目的 探讨结核感染T细胞斑点试验(T-SPOT.TB)检测在HIV/AIDS合并结核病诊断中的应用价值。方法 选取HIV阳性结核病患者44例、同期住院的HIV阴性结核病患者42例和HIV阳性非结核病患者28例。对3组患者的T-SPOT.TB、血结核抗体试验及外周血CD4+T细胞绝对计数等结果进行回顾性分析。结果 T-SPOT.TB对HIV阳性患者诊断结核病的灵敏度、特异度、阳性预测值、阴性预测值分别为81.82％、85.71％、90.00％、75.00％,其中灵敏度、阳性预测值与阴性预测值明显高于结核抗体检查,差异有统计学意义(P＜0.01)。HIV阳性结核病组T-SPOT.TB灵敏度(81.82％)与HIV阴性结核病组T-SPOT.TB灵敏度(83.33％)比较,差异无统计学意义(P=0.54),但HIV阳性结核病组结核抗体检查的灵敏度(25.00％)明显低于HIV阴性结核病组(57.14％)(P＜0.01)。HIV阳性结核病组中,T-SPOT.TB在菌阳肺结核、菌阴肺结核、肺外结核3种不同类型结核病患者中的灵敏度分别是71.43％、85.71％、88.89％,三者之间差异无统计学意义(P=0.586)。T-SPOT.TB在CD4+T淋巴细胞≤200个/μl的HIV合并结核病患者中的灵敏度为62.50%,低于CD4+T淋巴细胞＞200个/μl组(92.86%),差异有统计学意义(P=0.019)。结论 T-SPOT.TB灵敏度和特异度较高,对HIV/AIDS合并结核病具有较大的辅助诊断价值。CD4+T淋巴细胞的数量对T-SPOT.TB灵敏度有一定影响。 |
| 关键词: 结核感染T细胞斑点试验 人类免疫缺陷病毒 结核 |
| DOI：10.16118/j.1008-0392.2015.05.016 |
| 投稿时间：2014-12-18 |
| 基金项目: |
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| Clinical application of T-SPOT.TB in diagnosis of tuberculosis in patients with HIV infection |
| ZOU Dan-feng,XIAO He-ping,YIN Hong-yun |
| (Clinical and Research Center of Tuberculosis, Pulmonary Hospital, Tongji University, Shanghai 200433, China) |
| Abstract: |
| Objective To evaluate the effectiveness of T-SPOT.TB in diagnosis of tuberculosis in patients with HIV infection. Methods Forty-four patients diagnosed as pulmonary tuberculosis and HIV infection were admitted； 28 HIV positive patients without tuberculosis and 42 non-HIV positive patients with tuberculosis were admitted in the same period. T-SPOT.TB, blood TB antibody test and peripheral blood CD4+T cell counts were retrospectively analyzed in three groups. ResultsThe sensitivity, specificity, positive predictive value and negative predictive value of T-SPOT.TB test in HIV positive patients with tuberculosis were 81.82%, 85.71%, 90.00% and 75.00%, respectively, which were significantly higher than those of TB antibody test(P＜0.01). The sensitivity of T-SPOT.TB test in HIV positive patients with tuberculosis was not significantly different from that in HIV negative patients with tuberculosis(P=0.54). The sensitivity of TB antibody in HIV positive patients with tuberculosis(25.00%) was significantly lower than that in HIV negative patients with tuberculosis(57.14%)(P＜0.01). The sensitivity of T-SPOT. TB test in smear positive pulmonary tuberculosis, smear negative pulmonary tuberculosis and extra-pulmonary tuberculosis in the group of HIV positive patients with tuberculosis were 71.43%, 85.71% and 88.89%, respectively(P=0.586). The sensitivity of T-SPOT. TB test in HIV positive patients with tuberculosis and CD4+ T cells ＜200/ml was 62.5%, and that in patients in the same group but CD4+T cells ＞200/ml was 92.86%(P=0.019). Conclusion T-SPOT. TB is effective in diagnosis of tuberculosis in patients with HIV infection with high sensitivity and specificity, however, the number of CD4+T cells may reduce the diagnostic sensitivity to some extent. |
| Key words: T-SPOT human immunodeficiency virus tuberculosis |
