结核性胸腔积液诊断中T-SPOT.TB的敏感性和特异性分析

Sensitivity and specificity of T-SPOT. TB in the diagnosis of tuberculous pleural effusion

目的探讨结核性胸腔积液诊断中结核感染T细胞斑点实验(T-SPOT.TB)的敏感性和特异性。方法选取2015年3月至2016年3月不明原因胸腔积液患者116例,对其外周血和胸腔积液行T-SPOT.TB检测。比较结核性和非结核性胸腔积液患者阳性结果,分析T-SPOT.TB检测的敏感性和特异性。结果 116例患者中确诊结核性胸膜炎72例,非结核性胸腔积液44例。胸腔积液T-SPOT.TB诊断结核性胸膜炎的敏感性(94.4%)、特异性(95.4%)均明显高于外周血(83.3%、88.9%),且胸腔积液的阳性似然比高于外周血,阴性似然比低于外周血,差异均有统计学意义(P<0.05)。结论以胸腔积液为标本,采用T-SPOT.TB检测结核性胸腔积液的敏感性和特异性较佳。

Objective To investigate the sensitivity and specificity of T cell spot test（ T-SPOT. TB） in the diagnosis of tuberculous pleural effusion. Methods From March 2015 to March 2016,116 patients with unknown pleural effusion were selected,and the peripheral blood and pleural effusion samples were collected for T-SPOT. TB detection. The positive results were compared with the positive results in the patients with tuberculous and non tuberculous pleural effusion. The sensitivity and specificity of T-SPOT. TB were analyzed. Results Among the 116 patients,72 cases of tuberculous pleurisy,non tuberculous pleural effusion in 44 cases. The sensitivity（ 94. 4 %） and specificity（ 95. 4 %） of pleural effusion T-SPOT. TB in the diagnosis of tuberculosis pleurisy were higher than those of the peripheral blood（ 83. 3 %,88. 9 %）,and the positive likelihood ratio of pleural effusion was higher than that of the peripheral blood,the negative likelihood ratio was significantly lower than that of the peripheral blood,the differences were significant（ P 0. 05）.Conclusion The sensitivity and specificity of T-SPOT. TB for the detection of tuberculous pleural effusion is better than that of the pleural effusion.