Abstract: Objective　To evaluate the auxiliary diagnostic value of T cells spot test of Mycobacterium tuberculosis infection (T⁃SPOT.TB) for pulmonary and extra⁃pulmonary tuberculosis among the elderly. Methods　A total of 173 elderly patients at ages of 60 years and older and with suspected tuberculosis that were admitted to People’s Hospital of Xinjiang Uygur Autonomous Region during the period from October 2022 through February 2024 were enrolled, and all patients underwent T⁃SPOT.TB, acid fast staining and GeneXpert MTB/RIF tests. The etiological tests of MTB served as a gold standard, and the diagnostic values of T⁃SPOT.TB, acid fast staining and GeneXpert MTB/RIF tests for pulmonary and extra⁃pulmonary tuberculosis were compared among the elderly patients. Results　Of the 173 elderly patients suspected of tuberculosis, there were 44 patients definitely diagnosed with pulmonary tuberculosis, 30 cases with extra⁃pulmonary tuberculosis, and 99 cases without tuberculosis. The sensitivities of T⁃SPOT.TB, acid fast staining and GeneXpert MTB/RIF tests were 86.5%, 27.0% and 54.1% for diagnosis of tuberculosis. The sensitivities of T⁃SPOT.TB were 86.4% and 86.7% for diagnosis of pulmonary tuberculosis and extra⁃pulmonary tuberculosis, with an 80.8% specificity for diagnosis of tuberculosis. The sensitivities of GeneXpert MTB/RIF were 56.8% and 50.0% for diagnosis of pulmonary tuberculosis and extra⁃pulmonary tuberculosis, with a 100.0% specificity each, and the sensitivities of acid fast staining were 31.8% and 20.0% for diagnosis of pulmonary tuberculosis and extra⁃pulmonary tuberculosis, with a 100.0% specificity each. In addition, the areas under the receiver operating characteristic curve were 0.836, 0.635 and 0.770 for diagnosis of tuberculosis with T⁃SPOT.TB, acid fast staining and GeneXpert MTB/RIF tests among the elderly patients, respectively. Conclusion　T⁃SPOT.TB has a high auxiliary diagnostic value for both pulmonary and extra⁃pulmonary tuberculosis among elderly patients.

Key words: Pulmonary tuberculosis, Extra?pulmonary tuberculosis, T cells spot test, Auxiliary diagnosis, Diagnostic value

摘要： 目的　分析结核分枝杆菌（Mycobacterium tuberculosis，MTB）特异性T细胞斑点试验（T cells spot test of MTB infection，T⁃SPOT.TB）用于老年活动性肺结核和肺外结核患者的辅助诊断价值。方法　以2022年10月至2024年2月在新疆维吾尔自治区人民医院收治的173例≥ 60岁的疑似结核病患者作为研究对象。所有患者均行T⁃SPOT.TB、抗酸染色和MTB/利福平耐药实时荧光定量核酸扩增检测方法（GeneXpert MTB/RIF）检测，以MTB病原学诊断为金标准，比较T⁃SPOT.TB、抗酸染色和GeneXpert MTB/RIF法检测老年肺结核和肺外结核患者的效能。结果　 173例老年疑似结核病患者中，肺结核患者44例、肺外结核患者30例、非结核病患者99例。74例结核病确诊患者中，T⁃SPOT.TB法、抗酸染色法和GeneXpert MTB/RIF法检测灵敏度分别为86.5%、27.0%和54.1%。T⁃SPOT.TB法检测肺结核和肺外结核的灵敏度分别为86.4%和86.7%，检测结核病的特异度为80.8%；GeneXpert MTB/RIF法检测肺结核和肺外结核的灵敏度分别为56.8%和50.0%，特异度均为100.0%；抗酸染色法检测肺结核和肺外结核的灵敏度分别为31.8%和20.0%，特异度均为100.0%。T⁃SPOT.TB法、抗酸染色法和GeneXpert MTB/RIF法诊断老年结核病的受试者工作特征曲线下面积分别为0.836、0.635和0.770。结论　T⁃SPOT.TB法对老年肺结核和肺外结核患者均具有较高的辅助诊断价值。 　

关键词: 肺结核, 肺外结核, T细胞斑点试验, 辅助诊断, 诊断价值