發(fā)布時(shí)間：2018-04-24 08:01

  本文選題：分枝桿菌感染 + 皮膚　； 參考：《北京協(xié)和醫(yī)學(xué)院》2017年碩士論文

【摘要】：目的:探討結(jié)核感染T細(xì)胞檢測(cè)(T-SPOT.TB)在含RD1(Region of Difference 1)的分枝桿菌(包括結(jié)核分枝桿菌及含RD1的非結(jié)核分枝桿菌)皮膚感染中診斷和療效評(píng)估的價(jià)值。方法:前瞻性地研究2015年7月至2017年1月在本院診治的臨床及組織病理學(xué)檢查均疑似皮膚結(jié)核或非結(jié)核分枝桿菌感染的患者,排除其他臟器結(jié)核病的患者(包括現(xiàn)癥及既往感染),予于治療前行T-SPOT.TB檢測(cè)。對(duì)納入的患者的臨床表現(xiàn)、實(shí)驗(yàn)室檢查、診斷、治療方案、療效等進(jìn)行收集和分析。根據(jù)最終診斷將納入患者分為含RD1分枝桿菌皮膚感染組、其他診斷組(包括非RD1分枝桿菌皮膚感染、真菌感染等)。含RD1分枝桿菌皮膚感染的患者予抗分枝桿菌治療3月后再次行T-SPOT.TB檢查。分析T-SPOT.TB在含RD1的分枝桿菌皮膚感染中的診斷價(jià)值及判斷療效的價(jià)值。結(jié)果:共納入45例臨床及病理均疑似的患者,其中含RD1分枝桿菌皮膚感染組35例,其他診斷組10例。T-SPOT.TB在診斷含RD1的分枝桿菌皮膚感染的敏感度、特異度、陽(yáng)性預(yù)測(cè)值、陰性預(yù)測(cè)值分別為:85.7%、90.0%、96.8%、64.3%,其中T-SPOT.TB在診斷皮膚結(jié)核及含RD1非結(jié)核分枝桿菌(NTM)皮膚感染中的敏感度分別為100%、70.6%(P=0.013)。T-SPOT.TB的中位斑點(diǎn)形成細(xì)胞數(shù)(SFCs)在皮膚結(jié)核、含RD1的NTM皮膚感染及其他診斷的患者中分別為26.0、14.0和0(P=0.000)。確診含RD1的分枝桿菌皮膚感染的患者治療后T-SPOT.TB的陽(yáng)性率從 88.6%下降為 46.2%(P=0.000),中位 SFCs 從 16.0 降至 5.0(P=0.000)。結(jié)論:T-SPOT.TB在含RD1的分枝桿菌皮膚感染的診斷中有較好的診斷效能,特別是在皮膚結(jié)核中敏感度高,結(jié)合臨床、病理可協(xié)助皮膚分枝桿菌病的早期診斷。T-SPOT.TB的陽(yáng)性率、SFCs在含RD1的分枝桿菌皮膚感染治療后下降,可協(xié)助判斷療效。
[Abstract]:Objective: to investigate the value of T-SPOT.TB in the diagnosis and evaluation of cutaneous infection of Mycobacterium tuberculosis (including Mycobacterium tuberculosis and non-tuberculous bacillus) containing RD1(Region of Difference 1. Methods: a prospective study was conducted on patients suspected of skin tuberculosis or non-mycobacterium tuberculosis in clinical and histopathological examinations from July 2015 to January 2017. Patients excluding other visceral tuberculosis (including present and previous infections) were tested for T-SPOT.TB before treatment. Collect and analyze the clinical manifestation, laboratory examination, diagnosis, treatment plan, curative effect and so on. According to the final diagnosis, the patients will be divided into RD1 containing mycobacterium skin infection group, other diagnostic groups (including non- mycobacterium skin infection, fungal infection, etc.). Patients with skin infection of Mycobacterium RD1 were treated with T-SPOT.TB for 3 months. To analyze the diagnostic value of T-SPOT.TB in mycobacterium skin infection containing RD1 and the value of judging curative effect. Results: a total of 45 clinically and pathologically suspected patients were included, including 35 patients with mycobacterium RD1 skin infection and 10 patients with T-SPOT.TB in other diagnostic groups. The sensitivity, specificity and positive predictive value of T-SPOT.TB in the diagnosis of mycobacterial skin infection with RD1 were analyzed. The negative predictive values were 90.0 and 96.84.3.The sensitivity of T-SPOT.TB in the diagnosis of skin tuberculosis and skin infection containing RD1 non-tuberculous mycobacterium was 100% 70.6%, respectively. The median number of spot forming cells (SFCs) of T-SPOT.TB was 100%. The number of patients with NTM skin infection and other diagnoses with RD1 was 26.0V 14.0 and 0.000g, respectively. After treatment, the positive rate of T-SPOT.TB decreased from 88.6% to 46.2%, and the median SFCs decreased from 16.0 to 5.0%. ConclusionTwo T-SPOT.TB is effective in the diagnosis of mycobacterium skin infection with RD1, especially in skin tuberculosis. Pathology can assist in the early diagnosis of mycodermosis. The positive rate of T-SPOT.TB and the decrease of SFCs after the treatment of mycobacterial skin infection with RD1 may help to judge the curative effect.
【學(xué)位授予單位】：北京協(xié)和醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R754

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相關(guān)期刊論文 前2條

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本文編號(hào)：1795811