胸腔积液酶联免疫斑点检测对结核性胸膜炎的诊断价值

Enzyme-linked immunospot assay in diagnosis of tuberculous pleurisy

目的探讨胸腔积液酶联免疫斑点检测(enzyme-linked immunospot assay,ELISPOT)诊断结核性胸膜炎的临床价值。方法将收治的胸腔积液患者163例分为结核性胸膜炎组(结核组)103例和非结核性胸膜炎组(对照组)60例。对所有胸腔积液患者进行ELISPOT、腺苷脱氨酶(adenosine deaminase,ADA)检测。结果结核性胸腔积液中ELISPOT及ADA水平显著高于非结核性胸腔积液(P<0.01)。ELISPOT诊断结核性胸膜炎的敏感度(92.2%),高于ADA的敏感度(81.6%)。ELISPOT诊断结核性胸膜炎的特异度(93.3%),与ADA的特异度(91.7%)差异无统计学意义(P>0.05)。结论 ELISPOT诊断结核性胸膜炎敏感度高,同时具有很好的特异度,可作为诊断结核性胸膜炎的重要参考指标。

Objective To investigate the enzyme-linked immunospot assay（ELISPOT）in the diagnosis of tuberculous pleurisy.Methods A total of 163 pleural effusion patients admitted to hospital were enrolled.The patients were divided into tuberculous pleurisy group and non tuberculous pleurisy group.The pleural effusion in all patients was detected by ELISPOT and adenosine deaminase（ADA）activity was tested.Results ELISPOT and ADA activity were significantly higher in tuberculous pleural effusion than non tuberculous pleural effusion（P〈0.01）.The sensitivity for the tuberculous pleurisy diagnosis by ELISPOT 92.2%,was higher than ADA sensitivity,81.6%.The specificity for the tuberculous pleurisy diagnosis by ELISPOT93.3%,showed no significant difference as compared with ADA specificity,91.7%.ConclusionELISPOT can be a useful tool in diagnosing tuberculous pleurisy and is specific.