胸腔积液结核感染T细胞斑点实验检测对结核性胸膜炎的辅助诊断价值

THE AUXILIARY DIAGNOSTIC VALUE OF PLEURAL EFFUSION T-SPOT.TB DETECTION OF TUBERCULOUS PLEURISY

目的探讨结核感染T细胞斑点实验(T-SPOT.TB)在结核性胸膜炎临床辅助诊断的应用效果,评价T-SPOT.TB在诊断结核性胸膜炎中的价值。方法对该医院诊断、治疗的42例结核性胸膜炎患者相关资料进行分析,将其设置为结核性胸膜炎组,选择同期入院诊治的30例非结核性胸膜炎患者为非结核性胸膜炎组,对二组入院患者抽取胸腔积液,并采用T-SPOT.TB方法检测,分析T-SPOT.TB在结核性胸膜炎临床辅助诊断价值,判断其诊断结核性胸膜炎的敏感性和特异性。结果结核性患者中90.5%T-SPOT.TB检测阳性,高于非结核性患者(23.8%)(P<0.05);结核性患者13.3%T-SPOT.TB阴性,低于非结核性患者(P<0.05);确诊结核组病例42例中39例检测结果为阳性,检测敏感度92.8%(39/42),阳性预测值为92.8%,均高于对照组[检测结果阳性3例,阴性27例,特异度90%(27/30),阴性预测值为90%](P<0.05)。结论胸腔积液T-SPOT.TB检测法有较高的敏感度和特异度,对结核性胸膜炎有较大的辅助诊断价值,且这种诊断方法相对比较简单,值得推广使用。

Objective To investigate the TB infection T cell experiments spots（T-SPOT.TB）application results in clinical pleurisy diagnosis of tuberculous.Methods Patient-related data of forty-two cases of tuberculous pleurisy in author hospital diagnosis and treatment were analyzed,they were as tuberculous pleurisy group,at the same period,30 cases of patients with non-tuberculous pleurisy were as non-tuberculous pleurisy group.Two groups hospitalized patients with pleural effusion was extracted and TSPOT.TB was detected,then the clinical pleurisy diagnosis value of tuberculous by T-SPOT.TB was analyzed,sensitivity and specificity of the detection were confirmed.Results T-SPOT.TB test was positive in tuberculous patients of 90.5%,higher than non-tuberculosis patients（23.8%）（P〈0.05）;T-SPOT.TB-negative was in tuberculous patients of 13.3%,lower than non-tuberculosis patients（P〈0.05）.39 cases of 42 cases diagnosed TB patients were tested positive,the sensitivity of 92.8%（39/42）of patients to detect predictive value of 92.8%,were higher than the control group（three cases test positive,negative 27 cases,specificity of 90%（27/30）,negative predictive value was 90%）（P〈0.05）.Conclusion The pleural effusion T-SPOT.TB assay has greater diagnostic value with high sensitivity and specificity for tuberculous pleurisy,and this diagnostic method is relatively simple and should be introduced.