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目的探讨T细胞酶联免疫斑点法(T.SPOT-TB)在艾滋病合并结核病患者中的诊断价值。方法应用T.SPOT-TB对57例诊断明确的艾滋病合并结核病患者的血液样本进行检测并分析不同因素对T.SPOT-TB诊断价值的影响,同时对所有患者做结核菌素皮试(TST)试验进行比较。结果在艾滋病合并结核病的所有患者、肺结核组、肺外结核组、肺结核初治组、肺结核复治组的各组患者中,T.SPOT-TB的阳性检出率分别为80.70%、77.41%、88.46%、72.73%、80.00%;而TST试验的阳性检出率分别为22.81%、25.81%、19.23%、54.54%、10.00%。在患者总体、肺结核组、肺外结核组、复治组中,T.SPOT-TB检测的阳性检出率均高于TST试验(P<0.05)。结论对于MTB/HIV双重感染患者,T.SPOT-TB检测的敏感性高于目前常用的TST试验,且不受结核发病部位和初复治类型的影响,适用于我国艾滋病合并结核病的快速诊断。
Objective To investigate the diagnostic value of T cell immunospot assay (T.SPOT-TB) in AIDS patients with tuberculosis. Methods TSPOT-TB was used to detect blood samples of 57 patients with diagnosed HIV-positive TB and analyze the effect of different factors on the diagnostic value of T.SPOT-TB. Meanwhile, TST was performed on all patients. Test to compare. Results The positive rates of T.SPOT-TB were 80.70%, 77.41% in all patients with tuberculosis, pulmonary tuberculosis, extra-pulmonary tuberculosis, tuberculosis-naïve and tuberculosis relapsed. 88.46%, 72.73% and 80.00% respectively. The positive rates of TST test were 22.81%, 25.81%, 19.23%, 54.54% and 10.00%, respectively. In patients overall, tuberculosis group, extra-pulmonary tuberculosis group, retreatment group, the positive detection rate of T.SPOT-TB test was higher than the TST test (P <0.05). Conclusion The sensitivity of T.SPOT-TB test to patients with dual infection of MTB / HIV is higher than that of the commonly used TST test, and it is not affected by the incidence of tuberculosis and the type of primary relapse. It is suitable for the rapid diagnosis of HIV-associated tuberculosis in China.