脑脊液与外周血T-SPOT.TB对结核性脑膜炎诊断价值的比较

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Abstract Objective To evaluate the diagnostic value of T-SPOT.TB in cerebrospinal fluid for tuberculous meningitis. Methods A total of 147 inpatients of suspected tuberculous meningitis in the Department of TB Medicine of Hebei Chest Hospital from January 2012 to June 2016 were selected. Based on final diagnosis, 133 patients were divided into two groups: tuberculous meningitis group and non tuberculous meningitis group. The positive and the negative rates of T-SPOT.TB in cerebrospinal fluid and peripheral blood were compared. Results Among the patients, there were 76 cases of diagnosed tuberculous meningitis, and 57 cases of non tuberculous meningitis. The sensitivity of T-SPOT.TB in peripheral blood was 77.63%, compared with 63.16% of T-SPOT.TB in cerebrospinal fluid, there was no statistically significant difference (P > 0.05). The specificity of T-SPOT.TB in cerebrospinal fluid was 98.25%, significantly higher than 84.21% of T-SPOT.TB in peripheral blood, the difference was statistically significant (P < 0.05). The positive predictive value of T-SPOT.TB in cerebrospinal fluid was 97.96%, higher than 86.76% of T-SPOT.TB in peripheral blood, the difference was statistically significant (P < 0.05). The negative predictive value of T-SPOT.TB in peripheral blood was 73.85%, compared with 66.67% of T-SPOT.TB in cerebrospinal fluid, there was no statistically significant difference between the results (P > 0.05). Taking 96 SFCs/106PEMC as the cut-off value, the sensitivity, specificity, PPV, NPV and AUROC of T-SPOT.TB in cerebrospinal fluid in diagnosis of tuberculous meningitis were 90.79%, 98.25%, 98.57%, 88.89% and 0.993 (95%CI: 0.982-1.000), respectively. Conclusion Compared with T-SPOT.TB in peripheral blood, the T-SPOT.TB in cerebrospinal fluid can significantly improve the specificity and PPV, and accurate diagnosis level of tuberculous meningitis.

Key words： T-SPOT.TB Tuberculous meningitis Cerebrospinal fluid Peripheral blood Sensitivity Specificity

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	SONG Tao1 FU Hongyi1 LI Lijuan2

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SONG Tao1 FU Hongyi1 LI Lijuan2. A comparative study of the diagnostic value of T-SPOT.TB in cerebrospinal fluid and peripheral blood for tuberculous meningitis[J]. 中国医药导报, 2018, 15(16): 50-54.

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http://www.yiyaodaobao.com.cn/EN/ OR http://www.yiyaodaobao.com.cn/EN/Y2018/V15/I16/50

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