目的 分析结核分枝杆菌(Mycobacterium tuberculosis,MTB)特异性T细胞斑点试验(T cells spot test of MTB in-fection,T-SPOT.TB)用于老年活动性肺结核和肺外结核患者的辅助诊断价值.方法 以2022年10月至2024年2月在新疆维吾尔自治区人民医院收治的173例≥60岁的疑似结核病患者作为研究对象.所有患者均行T-SPOT.TB、抗酸染色和MTB/利福平耐药实时荧光定量核酸扩增检测方法(GeneXpert MTB/RIF)检测,以MTB病原学诊断为金标准,比较T-SPOT.TB、抗酸染色和GeneXpert MTB/RIF法检测老年肺结核和肺外结核患者的效能.结果 173例老年疑似结核病患者中,肺结核患者44例、肺外结核患者30例、非结核病患者99例.74例结核病确诊患者中,T-SPOT.TB法、抗酸染色法和GeneXpert MTB/RIF法检测灵敏度分别为86.5％、27.0％和54.1％.T-SPOT.TB法检测肺结核和肺外结核的灵敏度分别为86.4％和86.7％,检测结核病的特异度为80.8％;GeneXpert MTB/RIF法检测肺结核和肺外结核的灵敏度分别为56.8％和50.0％,特异度均为100.0％;抗酸染色法检测肺结核和肺外结核的灵敏度分别为31.8％和20.0％,特异度均为100.0％.T-SPOT.TB法、抗酸染色法和GeneXpert MTB/RIF法诊断老年结核病的受试者工作特征曲线下面积分别为0.836、0.635和0.770.结论 T-SPOT.TB法对老年肺结核和肺外结核患者均具有较高的辅助诊断价值.
Auxiliary diagnostic value of T cells spot test of Mycobacterium tuberculosis infection for pulmonary and extra-pulmonary tuberculosis among the elderly
Objective To evaluate the auxiliary diagnostic value of T cells spot test of Mycobacterium tuberculosis infection(T-SPOT.TB)for pulmonary and extra-pulmonary tuberculosis among the elderly.Methods A total of 173 elderly patients at ages of 60 years and older and with suspected tuberculosis that were admitted to People's Hospital of Xinjiang Uygur Autonomous Re-gion during the period from October 2022 through February 2024 were enrolled,and all patients underwent T-SPOT.TB,acid fast staining and GeneXpert MTB/RIF tests.The etiological tests of MTB served as a gold standard,and the diagnostic values of T-SPOT.TB,acid fast staining and GeneXpert MTB/RIF tests for pulmonary and extra-pulmonary tuberculosis were compared among the elderly patients.Results Of the 173 elderly patients suspected of tuberculosis,there were 44 patients definitely di-agnosed with pulmonary tuberculosis,30 cases with extra-pulmonary tuberculosis,and 99 cases without tuberculosis.The sensi-tivities of T-SPOT.TB,acid fast staining and GeneXpert MTB/RIF tests were 86.5％,27.0％and 54.1％for diagnosis of tuberculo-sis.The sensitivities of T-SPOT.TB were 86.4％and 86.7％for diagnosis of pulmonary tuberculosis and extra-pulmonary tubercu-losis,with an 80.8％specificity for diagnosis of tuberculosis.The sensitivities of GeneXpert MTB/RIF were 56.8％and 50.0％for diagnosis of pulmonary tuberculosis and extra-pulmonary tuberculosis,with a 100.0％specificity each,and the sensitivities of ac-id fast staining were 31.8％and 20.0％for diagnosis of pulmonary tuberculosis and extra-pulmonary tuberculosis,with a 100.0％specificity each.In addition,the areas under the receiver operating characteristic curve were 0.836,0.635 and 0.770 for diagno-sis of tuberculosis with T-SPOT.TB,acid fast staining and GeneXpert MTB/RIF tests among the elderly patients,respectively.Conclusion T-SPOT.TB has a high auxiliary diagnostic value for both pulmonary and extra-pulmonary tuberculosis among el-derly patients.
Pulmonary tuberculosisExtra-pulmonary tuberculosisT cells spot testAuxiliary diagnosisDiagnostic value
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