本文選題：兒童 + 結(jié)核　； 參考：《中國感染控制雜志》2017年11期

【摘要】：目的探討T淋巴細(xì)胞酶聯(lián)免疫斑點(diǎn)法(T-SPOT)在兒童結(jié)核病(TB)診斷中的應(yīng)用價(jià)值。方法選取2015年3月—2016年5月某院收治并確診的TB患兒43例作為結(jié)核組,隨機(jī)選取同期在該院門診及住院部排除結(jié)核感染的患兒及健康兒童50例作為對照組,分別對兩組進(jìn)行T-SPOTPPD結(jié)核抗體(MTB-Ab)及涂片抗酸染色等四種方法檢測和對比分析,并對T-SPOT法在結(jié)核組不同感染部位、不同年齡段患者的陽性情況進(jìn)行亞組分析。結(jié)果 T-SPOT在靈敏度和陰性預(yù)測值方面高于其余三種方法(P0.05),特異度也高于PPD法(P0.05);T-SPOT在肺內(nèi)結(jié)核和肺外結(jié)核中檢出的陽性率分別為88.9%和81.3%,差異無統(tǒng)計(jì)學(xué)意義(P0.05);在≤5歲和5歲兒童兩組之間的檢出率分別為70.6%和96.2%,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。采用T-SPOT法和PPD法兩種方法進(jìn)行并聯(lián)模式的結(jié)核檢測時(shí)的靈敏度為95.3%,特異度為98.0%,相比于單一方法檢測均有提高(P0.05)。結(jié)論 T-SPOT法在兒童TB檢測方面相對于傳統(tǒng)方法在靈敏度和特異度上均有優(yōu)勢,也適用于肺外結(jié)核的檢測,可作為兒童結(jié)核實(shí)驗(yàn)室診斷的主要方法,但在5歲以下兒童存在不確定性,應(yīng)合理聯(lián)合PPD法檢測,才能更好發(fā)揮在兒童TB診斷中的價(jià)值。
[Abstract]:Objective to evaluate the diagnostic value of T lymphocyte enzyme linked immunoblot assay (T-SPOT) in the diagnosis of children with tuberculosis (TB). Methods from March 2015 to May 2016, 43 children with TB were selected as tuberculosis group, 50 children who were excluded from tuberculosis infection in outpatient and inpatient department of the hospital and 50 healthy children were selected as control group. Four methods, MTB-Aband smear acid-fast staining, were detected and compared. The positive rate of T-SPOT method in different infection sites and age groups of tuberculosis patients was analyzed by subgroup analysis. Results the sensitivity and negative predictive value of T-SPOT were higher than those of the other three methods (P0.05A), and the specificity of T-SPOT was higher than that of PPD method. The positive rates of T-SPOT in pulmonary tuberculosis and extrapulmonary tuberculosis were 88.9% and 81.3%, respectively, and there was no significant difference between them in 鈮，

本文編號：1896784