| Objective: To explore the value of T-cell spot test for tuberculosis infection(T-SPOT.TB)in the diagnosis of tuberculosis and its influencing factors,and to provide valuable reference for the clinical diagnosis and treatment of tuberculosis.Methods: 325 hospitalized patients with suspected tuberculosis(TB)were recruited in the Chest Hospital of Anhui Province from January 2015 to May 2017 as the study objects.All of patients should be received the detection of T-cell spot test for tuberculosis infection(T-SPOT.TB),purified protein derivative(PPD),serum tuberculosis antibody(TB-Ab),and campared among of the sensitivity,specificity,false positive rate and false negative rate of three method in the diagnosis of tuberculosis.At the same time,the gender,age,serum albumin,indicators related blood routine,such as hemoglobin(Hb),lymphocyte(L),neutrophils(N),platelet(P),,NLR and PLR were analyzed to affect on the result of T-SPOT.TB in the diagnosis of tuberculosis(TB),and their relative analysis results were obtained from Logistic regression analysis.The statistical analysis was performed by using of SPSS22.0software.Results: 1.Of the 325 suspected TB patients,224 were male and 101 female,aged8-95 years old,with an average age of 50.11+19.83 years old.There were 254 cases of active tuberculosis,including 230 cases of pulmonary tuberculosis,24 cases of extrapulmonary tuberculosis and 71 cases of non-tuberculosis patients.The sensitivityof T-SPOT.TB,PPD and TB-Ab in the diagnosis of tuberculosis was 78.74%(200/254),54.72%(139/254)and 40.94%(104/254),respectively,the positive rate of whom was significantly higher than that of non-tuberculosis(23.94%,28.17% and 22.54%,respectively).Meanwhile,the positive rate of T-SPOT.TB in the diagnosis of tuberculosis was significantly higher than that of the other two methods(P<0.05).2.Logistic regression analysis showed that neutrophils and platelets did not pass the model significance test.The P value of gender and age was 0.2(p>0.05),The coefficient of total leukocytes on T-SPOT.TB was 0.158,but the P value was0.2(p>0.05),so they had no significant effect on T-SPOT.TB.The lymphocyte B value was 10.53,and the P value was 0.000(p<0.05),indicating a significant positive correlation between lymphocyte and T-SPOT.TB,with statistical significance.Both hemoglobin and albumin P values were greater than 0.05,with no significant effect on T-SPOT.TB.NLR(absolute value of neutrophil/lymphocyte)was-2.146 with a P value of 0.000(p>0.05).NLR had a statistically significant negative correlation with T-SPOT.TB.PLR(platelet count/lymphocyte absolute value)B value was-0.125,P value was 0.000(p>0.05),and PLR was negatively correlated with T-SPOT.TB(P<0.05).It was found that the higher the lymphocytes,the lower the NLR or PLR,and the more positive rate the T-SPOT.TB in the diagnosis of tuberculosis.Conclusion: 1.T-SPOT.TB has a higher sensitivity and specificity in the diagnosis of tuberculosis,and a higher application value compared with PPD and TB-Ab detection which is an important and effective method for assistant diagnosis of tuberculosis except for etiology.Therefore,the T-SPOT.TB test for patients with suspected tuberculosis can undoubtedly reduce the missed diagnosis of tuberculosis,and is also worth clinical application and promotion.2.Gender,age,hemoglobin and albumin had no significant effect on T-SPOT.TB,The absolute value of lymphocyte,NLR and PLR had some effects on T-SPOT.TB.The higher the lymphocyte was,the lower the NLR or PLR was,the more likely T-SPOT.TB would be positive.Therefore,the absolute value of lymphocyte,the influence of NLR and PLR on the results of T-SPOT.TB test should be considered for patients with suspected tuberculosis and comprehensive analysis and judgment are needed for the test results. |
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