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T-SPOT.TB 在结核病诊断中的临床意义 作者：戚超群
来源：《延边医学》2014年第15期
摘要:目的：探讨基于γ-干扰素释放的T 细胞斑点试验（T-SPOT.TB ）在结核病诊断中的意义。方法：首先对2013年1月-12月间在我院住院的肺结核病人30例，结核性胸膜炎30例，结核性脑膜炎9例进行T-SPOT.TB 检测，并分别对他们的血清、胸腔积液和脑脊液进行腺苷脱氨酶（ADA ）检测，在某医院职工进行年底查体时，采用T-SPOT.TB 对他们进行检测，对他们的血清进行ADA 检测，在保密个人信息的前提下，调查所有进行T-SPOT 试验的职工的健康状况。结果：肺结核病人30例，T-SPOT.TB 阳性30例,ADA 阳性25例，结核性胸膜炎30例，T-SPOT.TB 阳性30例，ADA 阳性27例，结核性脑膜炎9例，T-SPOT.TB 阳性9例，ADA 阳性5例。某医院共有420名工作人员查体，做T-SPOT 试验的共291人，阳性54人，阳性率为18.6%，阴性237人，经调查及询问本人发现，54人中有3人曾先后患肺结核并治疗，现已治愈停药。其他51人皆无症状（如：午后低热，盗汗等）、无体征（如：胸部X 光片无病变，包括钙化灶、无胸腔积液）、内科、外科检查无淋巴结肿大，无关节肿大、疼痛等，基本排除活动性结核病。结论：T-SPOT.TB 作为结核菌感染检测的最为准确的方法之一，敏感性极高，各种结核病病人都表现阳性，而感染过结核菌未发病的人一般也都表现为实验阳性，由此可见：T-SPOT.TB 阳性对结核病的诊断具有强大的支持作用，但存在一定的假阳性，而通过ADA 阳性诊断结核病存在一定的假阴性，两者联合，能明显提高阳性率和特异性；但T-SPOT.TB 检测阴性，基本可排除结核病（HIV 病人除外）［1］，对结核病的排除具有十分重要的意义。
关键词：T-SPOT.TB ，结核病，阴性排除
TO investigate the Clinical significance of T-SPOT.TB assay in thediagnosis of Tuberculosis Objective: To investigate the significance thatT-SPOT.TB assay based on the release of interferongamma in the diagnosis of tuberculosis.
Methods :First, Random select 30 Pulmonary tuberculosis cases,30 Tuberculous pleurisy cases and 9Tuberculous meningitis cases inpatient during 2013 Jan. to 2013 Dec. using T-SPOT.TB and ADA to detect them . When one hospital staffs check their bodies, in the case of informed consent, using T-SPOT.TB to detect them .Then survey their health status and pledge myself to a top secret. At the same time using T-SPOT.TB to detect 30 patients that been diagnosed and are receiving treatment for tuberculosis.
Results: T-SPOT.TB Positive numbers are:30 cases, 30 cases, 9 cases. ADA Positive numbers are 25 cases, 27 cases, 5 cases, There are 420 hospital staffs that check their bodies this time, andin the experiment of a total of 291 people, There are 54 people was positive, the positive rate was 18.6%, There are 237 people was negative. In fact, there are 3 people in 54 people had been suffered from tuberculosis and have now been cured. The other 51 people had no symptoms (such as: afternoon
龙源期刊网 http://www.qikan.com.cn
T-SPOT.TB 在结核病诊断中的临床意义 作者：戚超群
来源：《延边医学》2014年第15期
摘要:目的：探讨基于γ-干扰素释放的T 细胞斑点试验（T-SPOT.TB ）在结核病诊断中的意义。方法：首先对2013年1月-12月间在我院住院的肺结核病人30例，结核性胸膜炎30例，结核性脑膜炎9例进行T-SPOT.TB 检测，并分别对他们的血清、胸腔积液和脑脊液进行腺苷脱氨酶（ADA ）检测，在某医院职工进行年底查体时，采用T-SPOT.TB 对他们进行检测，对他们的血清进行ADA 检测，在保密个人信息的前提下，调查所有进行T-SPOT 试验的职工的健康状况。结果：肺结核病人30例，T-SPOT.TB 阳性30例,ADA 阳性25例，结核性胸膜炎30例，T-SPOT.TB 阳性30例，ADA 阳性27例，结核性脑膜炎9例，T-SPOT.TB 阳性9例，ADA 阳性5例。某医院共有420名工作人员查体，做T-SPOT 试验的共291人，阳性54人，阳性率为18.6%，阴性237人，经调查及询问本人发现，54人中有3人曾先后患肺结核并治疗，现已治愈停药。其他51人皆无症状（如：午后低热，盗汗等）、无体征（如：胸部X 光片无病变，包括钙化灶、无胸腔积液）、内科、外科检查无淋巴结肿大，无关节肿大、疼痛等，基本排除活动性结核病。结论：T-SPOT.TB 作为结核菌感染检测的最为准确的方法之一，敏感性极高，各种结核病病人都表现阳性，而感染过结核菌未发病的人一般也都表现为实验阳性，由此可见：T-SPOT.TB 阳性对结核病的诊断具有强大的支持作用，但存在一定的假阳性，而通过ADA 阳性诊断结核病存在一定的假阴性，两者联合，能明显提高阳性率和特异性；但T-SPOT.TB 检测阴性，基本可排除结核病（HIV 病人除外）［1］，对结核病的排除具有十分重要的意义。
关键词：T-SPOT.TB ，结核病，阴性排除
TO investigate the Clinical significance of T-SPOT.TB assay in thediagnosis of Tuberculosis Objective: To investigate the significance thatT-SPOT.TB assay based on the release of interferongamma in the diagnosis of tuberculosis.
Methods :First, Random select 30 Pulmonary tuberculosis cases,30 Tuberculous pleurisy cases and 9Tuberculous meningitis cases inpatient during 2013 Jan. to 2013 Dec. using T-SPOT.TB and ADA to detect them . When one hospital staffs check their bodies, in the case of informed consent, using T-SPOT.TB to detect them .Then survey their health status and pledge myself to a top secret. At the same time using T-SPOT.TB to detect 30 patients that been diagnosed and are receiving treatment for tuberculosis.
Results: T-SPOT.TB Positive numbers are:30 cases, 30 cases, 9 cases. ADA Positive numbers are 25 cases, 27 cases, 5 cases, There are 420 hospital staffs that check their bodies this time, andin the experiment of a total of 291 people, There are 54 people was positive, the positive rate was 18.6%, There are 237 people was negative. In fact, there are 3 people in 54 people had been suffered from tuberculosis and have now been cured. The other 51 people had no symptoms (such as: afternoon