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目的探讨结核感染T细胞斑点试验(T-SPOT.TB)在克罗恩病(Crohns disease,CD)和肠结核(intestinal tuberculosis,ITB)鉴别诊断中的价值。方法采用T-SPOT.TB检测26例CD、22例ITB患者静脉血标本,统计分析T-SPOT.TB在CD和ITB中的阳性率及诊断ITB的敏感度、特异度、阳性预测值和阴性预测值,比较T-SPOT.TB与结核菌素纯蛋白衍生物试验(purified protein derivative of tuberculin,PPD)诊断ITB的准确度。结果 T-SPOT.TB诊断CD、ITB的阳性率分别为7.7%、77.3%,差异有统计学意义(P<0.05);T-SPOT.TB诊断ITB的敏感度、特异度、阳性预测值和阴性预测值分别为77.3%、92.3%、89.5%和82.8%,准确度(85.4%)高于PPD(63.3%)(P<0.05);与PPD联合诊断ITB的敏感度、特异度、阳性预测值和阴性预测值分别为86.4%、65.4%、67.9%和85.0%,其准确度为75.0%。结论 T-SPOT.TB有助于鉴别CD和ITB,与PPD检测联合诊断ITB的敏感度较高。
Objective To investigate the value of T-SPOT.TB in the differential diagnosis of Crohn’s disease (CD) and intestinal tuberculosis (ITB). Methods T-SPOT.TB was used to detect the venous blood samples of 26 patients with CD and 22 patients with ITB. The positive rate of T-SPOT.TB in CD and ITB and the sensitivity, specificity, positive predictive value and negative Predictors were compared with T-SPOT.TB and purified protein derivative of tuberculin (PPD) to diagnose the accuracy of ITB. Results The positive rate of T-SPOT.TB in diagnosing CDB and ITB was 7.7% and 77.3%, respectively (P <0.05). The sensitivity, specificity and positive predictive value of T-SPOT.TB in diagnosis of ITB The negative predictive value was 77.3%, 92.3%, 89.5% and 82.8% respectively, and the accuracy was 85.4%, which was higher than that of PPD (63.3%) (P <0.05). The sensitivity, specificity and positive predictive value The values and negative predictive values were 86.4%, 65.4%, 67.9% and 85.0%, respectively, with an accuracy of 75.0%. Conclusion T-SPOT.TB can help identify CD and ITB, and has a higher sensitivity in diagnosing ITB with PPD.