T细胞酶联免疫斑点试验在结核性胸膜炎鉴别诊断中的应用价值

Application value of T cell enzyme-linked immune spot test in differential diagnosis of tuberculous pleurisy

目的:探讨T细胞酶联免疫斑点试验(T-SPOT·TB)在结核性胸膜炎鉴别诊断中的应用价值。方法:对2013年9月至2015年1日住院治疗的61例疑似结核性胸膜炎致胸腔积液患者(A组)和44例其他疾病致胸腔积液(B组)的患者进行外周血T-SPOT·TB检测,所有患者同时进行结核菌素试验(PPD)、血清结核抗体检测(Mtb-AB)并对比,结果与最终诊断比较。结果:A组T-SPOT·TB的阳性率为90.9%,明显高于B组的20.5%(χ2=52.19,P<0.001)。A组T-SPOT·TB的阳性率明显高于PPD试验的54%(χ2=19.74,P<0.01)、Mtb-AB检测的41%(χ2=32.68,P<0.01)。T-SPOT·TB在B组中阴性率为79.5%。结论:T-SPOT·TB检测特异性和敏感度要明显优于PPD试验和Mtb-AB检测,可用于结核性胸膜炎的鉴别诊断,值得临床推广应用。

Objective To investigate the application value of T cell enzyme-linked immune SPOT test （T-SPOT·TB） in the differential diagnosis of tuberculous pleurisy. Methods From September 2013 to January 2015, 61 hospitalized with suspected tuberculosis pleurisy pleural effusion patients （group A） and 44 cases of other diseases caused by pleural effusion patients （group B） had peripheral blood T-SPOT-TB testing. All patients simultaneously had tuberculin test （PPD） and serum tuberculosis antibody detection （Mtb-AB）. Then the comparison was carried out between the results and the final diagnosis. Results T-SPOT-TB positive rate in group A was 90.9%, which was significantly higher than that of group B （20.5%） （X2 = 52.19, P 〈 0.001）. The positive rate of T-SPOT.TB in group A was obviously higher than that of PPD test （54%,χ^2=19.74, P 〈 0.01 ） and that of MtbAB （41%, χ^2= 32.68, P 〈 0.01）. T-SPOT-TB negative rate was 79.5% in group B. Conclusion The specificity and sensitivity of T-SPOT·TB detection are significantly better than those of PPD test and Mtb-AB detection and it can be used in the differential diagnosis of tuberculous pleurisy and worthy of clinical popularization and application.