结核感染T细胞斑点试验在小儿结核诊断中的应用研究

摘要

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 charac-ter,clinical manifestation and diagnosis,PPD and T-SPOT.TB testing result were collected.According to the results of clinical diag-nosis,the diagnostic value of the two tests were evaluated and compared with each other.Results Thirteen patients had culture-con-firmed 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 ).Conclu-sions 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.%目的：探讨结核感染 T 细胞斑点试验（T-SPOT．TB）在小儿结核诊断中的应用价值。方法回顾性分析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（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，差异有统计学意义（P ＜0．05）。结论T-SPOT．TB 检测诊断小儿结核的敏感性、特异性均较高。T-SPOT．TB 检测可辅助诊断小儿结核，阴性结果有助于排除小儿结核。