结核性胸膜炎胸膜组织病理学检查及胸水检测的诊断价值

Value of histopathological examination and pleural effusion detection of tuberculosis pleurisy

目的探索超声引导下胸膜活检、胸水结核分枝杆菌-PCR(TB-PCR)、腺苷脱氨酶(ADA)联合检测对结核性胸膜炎的诊断价值。方法选取80例结核性胸腔积液患者为观察组,均行超声引导下胸膜活检;另选取非结核性胸腔积液患者60例作为对照组,检测并比较两组患者胸水中的TB-PCR及胸水腺苷脱氨酶(ADA)活性。结果观察组患者经胸膜活检阳性率为81.3%,胸水TB-PCR检测阳性率为66.3%,胸水ADA检测阳性率为88.8%,两者均明显高于对照组(P<0.05)。三者综合诊断结核性胸膜炎阳性率(97.5%)显著高于单独应用(P<0.05)。结论超声引导下胸膜活检、胸水TB-PCR、ADA的检测均是结核性胸膜炎检测的有效手段,三者综合应用诊断阳性率明显提高。

Objective To explore the diagnostic value of ultrasound-guided pleural biopsy, pleural effusion Mycobacterium tuberculosis-PCR （TB-PCR）, adenosine deaminase （ADA） combined detection in tuberculosis pleurisy. Methods 80 patients with tuberculosis pleural effusion were chosen as the observation group, underwent ultrasound-guided pleural biopsy. Another 60 patients with non-tuberculosis pleural effusion were as the control group. TB-PCR pleural fluid and pleural fluid adenosine dea^inase （ADA） activity of two groups were detected and compared. Results The positive rate of pleural biopsy was 81. 3 %. Pleural TB-PCR test positive rate was 66.3 %. The pleural effusion ADA testing positive rate was 88.8%, both significantly higher than the control（P〈0.05）. The positive rate of comprehensive diagnosis of tuberculosis pleurisy was significantly higher than alone （P〈0.05）. Conclusion Ultrasound-guided pleural biopsy, pleural TB-PCR, ADA detection are effective in the detection of tuberculosis pleurisy.