比较3种检测方法在骨关节结核早期临床诊断中的应用

摘要
图/表
参考文献
相关文章 (0)

全文: PDF (2148 KB) HTML (0 KB)
输出: BibTeX | EndNote (RIS)

摘要 目的: 探讨在骨关节结核早期临床诊断中,结核感染T细胞斑点试验（T-SPOT.TB）、结核菌素（PPD）检测和结核抗体检测（LAM-IgG）的临床应用价值。方法: 选取2019年1月―2021年7月期间在我院骨科病区接诊的疑似骨关节结核患者,均使用了三种检测方法诊断：结核感染T细胞斑点试验（T-SPOT.TB）、结核菌素（PPD）检测和结核抗体检测（LAM-IgG）。比较三种诊断方法的差异评分,包括特异性、敏感性和假阳性率（FPR）,评估三种检测方法在诊断骨关节结核中的临床价值。结果: T-SPOT.TB对骨关节结核的诊断中,敏感性明显高于PPD试验和结核抗体试验（LAM-IgG）;特异度高于PPD皮试;特异度与结核抗体（LAM-IgG）试验比较无显著差异;T-SPOT.TB的假阳性率低于PPD试验;T-SPOT.TB的假阳性率与结核抗体（LAM-IgG）测试比较无显著差异。结论: 对骨关节结核早期诊断,T-SPOT.TB具有优异的敏感性和特异性,是骨关节结核早期重要的辅助诊断指标。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	刘晓富
	庞菁

关键词 ：检测方法, 骨关节结核, 结核感染T细胞斑点试验, 结核抗体试验

Abstract：Objective To investigate the clinical value of T-SPOT. TB, PPD and LAM-IgG in the early diagnosis of osteoarticular tuberculosis. Methods Ninety-one patients with suspected bosteoarticular uberculosis admitted from January 2019 to July 2021 were selected for the cell spot test (T-SPOT. TB), pure protein derivative (PPD) test and tuberculosis antibody (LAM-IgG) test to diagnose patients, compare the specificity, sensitivity, false positive rate (FPR) and other indicators of the three diagnostic methods, and evaluate their clinical value in the diagnosis of bone and joint tuberculosis. Results The sensitivity of T cell spot test was significantly higher than that of PPD test and tuberculosis antibody test (LAM-IgG), and the specificity was higher than that of PPD skin test. There was no significant difference between the specificity of T-SPOT.TB and LAM-IgG. The false positive rate of T-SPOT. TB was significantly lower than that of PPD test; There was no significant difference between the false-positive rate of T-SPOT.TB and LAM-IgG. Conclusion T-SPOT. TB has excellent sensitivity and specificity in the early diagnosis of osteoarticular tuberculosis and is an important auxiliary diagnostic index in the early diagnosis of osteoarticular tuberculosis.

Key words： detection method osteoarticular tuberculosis tuberculosis infection T cell spot test tuberculosis antibody (LAM-IgG) test

收稿日期: 2022-03-29

中图分类号:

R529.2

通讯作者: 庞菁,E-mail：2248634873 @qq.com

引用本文:

刘晓富, 庞菁. 比较3种检测方法在骨关节结核早期临床诊断中的应用[J]. 湖南师范大学学报(医学版), 2023, 20(1): 108-110. LIU Xiaofu, PANG Jing. Comparison of three detection methods in the early clinical diagnosis of osteoarticular tuberculosis. HuNan ShiFan DaXue XueBao(YiXueBan), 2023, 20(1): 108-110.

链接本文:

http://yxb.hunnu.edu.cn/CN/ 或 http://yxb.hunnu.edu.cn/CN/Y2023/V20/I1/108

[1] 张晓梅, 黄鹏. 结核感染T细胞斑点试验在结核病临床诊断中的应用[J]. 南昌大学学报 (医学版), 2020, 60(6): 71-75.
[2] 宋韬, 李莉娟, 付洪义, 等. 结核感染T细胞斑点试验在肺结核合并艾滋病患者中的诊断和影响分析[J]. 中国临床医生杂志, 2019, 47(12): 44-46.
[3] 宋斌, 崔红艳. 磁共振成像对骨结核和骨肿瘤的诊断价值分析[J]. 中国医药指南, 2019, 17(3): 135-136.
[4] 葛肖肖, 彭灿辉. 结核感染T淋巴细胞γ干扰素释放试验在骨关节结核诊断中的应用[J]. 中华临床实验室管理电子杂志, 2018, 6(3): 153-156.
[5] Holland TS, Sangster MJ, Paton RW, et al.Bone and joint tuberculosis in children in the Blackburn area since 2006: a case series[J]. J Child Orthop, 2010, 4(1): 67-71.
[6] 马远征, 胡明, 才晓军, 等. 脊柱结核外科治疗的探讨[J]. 中华骨科杂志, 2005, 25(2): 68-73.
[7] 骨关节结核临床诊断与治疗进展及其规范化专题研讨会学术委员会. 正确理解和认识骨与关节结核诊疗的若干问题[J]. 中国防痨杂志, 2013, 35(5): 384-392.
[8] 程新平, 车立新, 李坤, 等. 新疆骨结核临床特点初步分析[J]. 实用骨科学杂志, 2011, 17(5): 421-423.
[9] Christopoulos A, Saif M W, Sarris E G, et al.Epidemiology of active tuberculosis in lung cancer patients: a systematic review[J]. Clin Respir J, 2014, 8(4): 375-381.
[10] Green A M, Difazio R, Flynn J L.IFN-γ from CD4 t Cells is essential for host survival and enhances CD8 T cell function during Mycobacterium tuberculoss infection[J]. J Immunol, 2013, 190(1): 270-277.
[11] 章静, 陆雪儿, 赵盼. 外周血T-SPOT. TB和胸腔积液中ADA、LDH对结核性胸膜炎的诊断价值[J]. 职业卫生与应急救援, 2019, 1(2): 126-129.
[12] 王黎霞, 成诗明, 周林, 等. 中华人民共和国卫生行业标准肺结核诊断: WS288-2017[J]. 中国感染控制杂志, 2018, 17(7): 642-652.
[13] 华裕忠, 程绍云, 姜国红, 等. 结核感染T细胞干扰素释放试验检测在脊柱结核快速诊断中的应用[J]. 中华医学杂志, 2016, 96(27): 2179-2181.
[14] 张晓梅, 黄鹏. 结核感染T细胞斑点试验在结核病诊断中的应用[J]. 南昌大学学报 (医学版), 2020, 60(6): 71-75.
[15] Shaikh N, Gcpte A, Dharmshal E S, et al.Novel interferon-gamma assays for diagnosing tuberculosis in young children in india[J]. Int J Tuber Lung Dis, 2017, 21(4): 412-419.
[16] Zhou Zibo, Zheng Yan, Wang Leiming.A comparative study on the value of Xpert MTB/RIF and T-SPOT. TB tests in the diagnosis of bone an joint tuberculosis[J]. Clin Chim Acta, 2020, 1(500): 115-119.
[17] 吴青. 结核感染T细胞斑点试验在辅助诊断骨结核中的应用价值[J]. 广西医学, 2016, 38(12): 1649-1651.
[18] Wang L, Yu Y, Chen W, et al.Evaluationg of the characteristics of the enzyme-linked immunospot assay diagnosis of active tubeiculosis in China[J]. Clin Vaccine Immunol, 2015, 22(5): 510-515.
[19] 王淑琪, 孙晴, 姜广路, 等. 第二次实时免疫荧光定量核酸扩增检测在结核病诊断中的增值成本效益分析[J]. 中华结核和呼吸杂志, 2019, 2(6): 432-437.
[20] 刘晓富, 肖经难, 王起, 等. 膝关节结核的临床诊和治疗分析[J]. 湘南学院学报, 2013, 15(4): 34-35.