T-SPOT.TB联合XpertMTB/RIF在老年艾滋病患者合并结核分枝杆菌感染中的诊断价值

doi:10.16352/j.issn.1001-6325.2025.10.1350

基础医学与临床 ›› 2025, Vol. 45 ›› Issue (10): 1350-1355.doi: 10.16352/j.issn.1001-6325.2025.10.1350

T-SPOT.TB联合XpertMTB/RIF在老年艾滋病患者合并结核分枝杆菌感染中的诊断价值

曹亚伟^1*, 周保仓², 王倩³, 王存丽⁴, 刘灿⁵, 刘长力¹

衡水市第三人民医院 1.呼吸科; 2.消化一科; 3.医保科,河北衡水 053000;
4.衡水市第五人民医院妇产科,河北衡水 053000;
5.衡水市第二人民医院内科,河北衡水 053000

收稿日期:2024-10-29 修回日期:2025-01-03 出版日期:2025-10-05 发布日期:2025-09-22
通讯作者: ^*xvt8658937532@163.com
基金资助:
衡水市重点研发计划项目(2023014004Z)

Diagnostic value of T-SPOT.TB combined with XpertMTB/RIF in elderly AIDS patients with Mycobacterium tuberculosis infection

CAO Yawei^1*, ZHOU Baocang², WANG Qian³, WANG Cunli⁴, LIU Can⁵, LIU Changli¹

1. Department of Respiration; 2. Department of Gastroenterology; 3. Department of Medical Insurance, Hengshui Third People's Hospital,Hengshui 053000;
4. Department of Obstetrics and Gynecology, the Fifth People's Hospital of Hengshui 053000;
5. Department of Internal Medicine, the Second People's Hospital of Hengshui, Hengshui 053000, China

Received:2024-10-29 Revised:2025-01-03 Online:2025-10-05 Published:2025-09-22
Contact: ^*xvt8658937532@163.com

摘要/Abstract

摘要： 目的探讨T细胞酶联免疫斑点法(T-SPOT.TB)联合利福平耐药结核分枝杆菌实时荧光定量核酸扩增检测技术(XpertMTB/RIF)在老年艾滋病患者合并结核分枝杆菌(MTB)感染中的诊断价值。方法选取衡水市第三人民医院2022年5月至2024年5月收治的86例老年艾滋病疑似MTB患者,根据病理检查结果分为艾滋病合并MTB(研究组)和艾滋病非MTB(对照组);均进行MTB培养、T-SPOT.TB和XpertMTB/RIF检测;Kappa分析T-SPOT.TB联合XpertMTB/RIF诊断艾滋病合并MTB与金标准的一致性;绘制ROC曲线以及四格表分析T-SPOT.TB联合XpertMTB/RIF诊断艾滋病合并MTB感染的价值。结果研究组血γ-干扰素、T-SPOT.TB阳性检出率以及XpertMTB/RIF阳性检出率均高于对照组(P＜0.05)。T-SPOT.TB诊断艾滋病合并MTB感染的AUC为0.810,XpertMTB/RIF诊断艾滋病合并MTB感染的AUC为0.835,二者联合诊断艾滋病合并MTB感染的AUC为0.910。T-SPOT.TB、XpertMTB/RIF及联合诊断艾滋病合并MTB感染的Kappa值分别为0.624、0.674和0.825。T-SPOT.TB诊断艾滋病合并MTB阴阳性的准确度为82.56%,XpertMTB/RIF诊断艾滋病合并MTB阴阳性的准确度为84.88%,二者联合诊断艾滋病合并MTB阴阳性的准确度为91.86%。结论 T-SPOT.TB联合XpertMTB/RIF可提高诊断艾滋病合并MTB准确度,可作为临床辅助诊断艾滋病合并MTB的方法。

关键词: T细胞酶联免疫斑点法, 利福平耐药结核分枝杆菌实时荧光定量核酸扩增检测技术, 艾滋病, 结核分枝杆菌

Abstract: Objective Exploring the diagnostic value of T-cell enzyme-linked immunospot assay (T-SPOT.TB) combined with rifampicin-resistant Mycobacterium tuberculosis real-time fluorescence quantitative nucleic acid amplification detection (XpertMTB/RIF) in geriatric AIDS patients with Mycobacterium tuberculosis(MTB) infection. Methods From May 2022 to May 2024, 86 elderly patients with AIDS suspected MTB in Hengshui Third People's Hospital were gathered and separated into AIDS complicated with MTB (research group) and AIDS without MTB (control group) according to the pathological examination results. MTB culture, T-SPOT.TB and XpertMTB/RIF were performed. Kappa analysis was applied to evaluate the consistency between T-SPOT.TB combined with XpertMTB/RIF and the gold standard for diagnosing MTB coinfection in AIDS patients. ROC curve and four grid table were plotted to analyze the value of the combination of T-SPOT.TB and XpertMTB/RIF in the diagnosis of AIDS complicated with MTB infection. Results The blood γ-interferon, the positive detection rates of T-SPOT.TB and XpertMTB/RIF in the research group were higher than those in the control group (P＜0.05). The AUC of T-SPOT.TB in diagnosing AIDS with MTB infection was 0.810, that of Xpert MTB/RIF in diagnosing AIDS with MTB infection was 0.835, and the AUC of the two in diagnosing AIDS with MTB infection was 0.910. The Kappa values of T-SPOT.TB, Xpert MTB/RIF and their combined diagnosis for AIDS with MTB infection were 0.624, 0.674 and 0.825, respectively. The accuracy of T-SPOT.TB in the diagnosis of AIDS with MTB was 82.56%, the accuracy of XpertMTB/RIF in the diagnosis of AIDS with MTB was 84.88%, and the accuracy of the combined diagnosis for AIDS with MTB was 91.86%. Conclusions T-SPOT.TB combined with XpertMTB/RIF can improve the accuracy of diagnosis of AIDS with MTB, and can be used as a clinical auxiliary diagnosis method for AIDS patients complicated with MTB.

Key words: T cell enzyme-linked immunospot assay, rifampicin-resistant real-time fluorescence quantitative nucleic acid amplification detection technology, acquired immunodeficiency syndrome, Mycobacterium tuberculosis

中图分类号:

R446.5

曹亚伟, 周保仓, 王倩, 王存丽, 刘灿, 刘长力. T-SPOT.TB联合XpertMTB/RIF在老年艾滋病患者合并结核分枝杆菌感染中的诊断价值[J]. 基础医学与临床, 2025, 45(10): 1350-1355.

CAO Yawei, ZHOU Baocang, WANG Qian, WANG Cunli, LIU Can, LIU Changli. Diagnostic value of T-SPOT.TB combined with XpertMTB/RIF in elderly AIDS patients with Mycobacterium tuberculosis infection[J]. Basic & Clinical Medicine, 2025, 45(10): 1350-1355.

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T-SPOT.TB联合XpertMTB/RIF在老年艾滋病患者合并结核分枝杆菌感染中的诊断价值

Diagnostic value of T-SPOT.TB combined with XpertMTB/RIF in elderly AIDS patients with Mycobacterium tuberculosis infection

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