T细胞斑点试验与痰涂片检查在成人不同年龄段肺结核 诊断中的结果分析

doi:10.19871/j.cnki.xfcrbzz.2022.04.012

摘要/Abstract

摘要： 目的对比分析结核感染T细胞斑点试验（T-SPOT.TB）及痰涂片检查在成人不同年龄段肺结核诊断中的临床意义。方法选取2018年3月至2019年12月在海南省文昌市人民医院就诊的650例疑似肺结核患者资料进行回顾性分析,将入选者按照世界卫生组织年龄分段进行分组,青年组（18~44岁）296例、中年组（45~59岁）144例及老年组（≥60岁）210例。所有患者行T-SPOT.TB及痰涂片检查,比较在不同年龄段肺结核患者中两种检查方法的检测阳性率。利用ROC曲线判断T-SPOT.TB试验中A抗原、B抗原在不同年龄段肺结核患者的诊断价值;分析T-SPOT.TB在成人不同年龄段肺结核的诊断效能。结果 ①在不同年龄组中T-SPOT.TB检测阳性率明显高于痰涂片法,差异均有统计学意义（P<0.05）。②在不同年龄段中T-SPOT.TB检测的灵敏度和准确度间比较,差异有统计学意义（P<0.05）;T-SPOT.TB对青年组、中年组、老年组的诊断灵敏度分别为92.72%、79.81%、64.52%,两两比较差异均有统计学意义（P<0.0166）;T-SPOT.TB对老年组的诊断准确度为67.14%,分别低于青年组的86.15%及中年组的75.69%,各组间比较差异均有统计学意义（P<0.0166）。结论 T-SPOT.TB检测方法对青年及中年患者诊断灵敏度和准确度均高于老年,对老年肺结核诊断效能较低,需结合其他诊断方法,避免误诊、漏诊。

关键词: T细胞斑点试验, 痰涂片检查, 肺结核, 感染, 诊断, 年龄

Abstract: Objective To analyze the clinical significance of T-SPOT test (T-SPOT.TB) and sputum smear examination in the diagnosis of pulmonary tuberculosis in adults of different ages. Method The data of 650 patients with suspected pulmonary tuberculosis treated in our hospital from March 2018 to December 2019 were retrospectively analyzed. The participants were divided into young group (18-44 years old) 296 cases, middle-aged group (45-59 years old) 144 cases and elderly group (≥60 years old)210 cases according to the age of the World Health Organization. All patients were examined with T-SPOT.TB and sputum smear, The positive rates of the two methods in different age groups were compared.The diagnostic value of a antigen and B antigen in patients with pulmonary tuberculosis at different ages was judged by the working characteristic curve of subjects. To analyze the diagnostic efficacy of T-SPOT.TB in adult tuberculosis of different ages. Result ① In different age groups, the positive rate of T-SPOT.TB was significantly higher than that of sputum smear method, and the difference was statistically significant (P<0.05). ② There was significant difference between the sensitivity and accuracy of T-SPOT.TB detection in different age groups (P<0.05); The diagnostic sensitivity of T-SPOT.TB for young group, middle-aged group and old group were 92.72%, 79.81% and 64.52% respectively, and the difference was statistically significant (P<0.0166); The diagnostic accuracy of T-SPOT.TB in the elderly group was 67.14%, which was lower than 86.15% in the youth group and 75.69% in the middle-aged group, respectively. There was significant difference between the groups (P<0.0166). Conclusion The diagnostic sensitivity and accuracy of T-SPOT.TB detection method in young and middle-aged patients are higher than that in elderly patients, and the diagnostic efficiency of tuberculosis in elderly patients is low. It should be combined with other diagnostic methods to avoid misdiagnosis and missed diagnosis.

Key words: T cell spot test, Sputum smear examination, Pulmonary tuberculosis, Infected, Diagnosis, Age

符雄, 符林琳, 符秋叶, 吴伟珍. T细胞斑点试验与痰涂片检查在成人不同年龄段肺结核诊断中的结果分析[J]. 新发传染病电子杂志, 2022, 7(4): 53-56.

Fu Xiong, Fu Linlin, Fu Qiuye, Wu Weizhen. Comparison of T cell spot test and sputum smear in the diagnosis of pulmonary tuberculosis in adults of different ages[J]. Electronic Journal of Emerging Infectious Diseases, 2022, 7(4): 53-56.

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