结核分枝杆菌T细胞斑点试验诊断结核性胸膜炎的临床价值

Clinical value of Mycobacterium tuberculosis T-cell spot test in the diagnosis of tuberculous pleurisy

目的探讨结核分枝杆菌T细胞斑点试验(T-SPOT·TB)技术诊断结核性胸膜炎的临床价值。方法选择2015年1月至2016年3月于我院就诊的176例疑似结核性胸膜炎的患者作为研究对象,使用T-SPOT·TB技术检测外周血单个核细胞中对结核分枝杆菌早期分泌靶抗原6(ESAT-6)和/或培养滤液蛋白10(CFP-10)致敏的T细胞,并将T-SPOT·TB技术的检测结果与腺苷脱氢酶(ADA)、PPD皮内试验、胸水结核分枝杆菌聚合酶链反应(TB-DNA)进行对比。结果 T-SPOT·TB技术检测的准确性为92.05%,特异度为92.31%,灵敏度为92.00%,均明显优于TB-DNA、ADA、PPD等检测方法(P<0.05)。结论 TSPOT·TB技术较适用于结核性胸膜炎的诊断中,特异度、灵敏度与准确性均明显高于其他检测方法,值得临床推广应用。

Objective To investigate the clinical value of Myeobacterium tuberculosis T-cell spot （T-SPOT-TB） test in the diagnosis of tuberculous pleurisy. Methods One hundred and seventy-six patients with suspected tuberculous pleurisy in our hospital from January 2015 to March 2016 were selected as the research objects. T-SPOToTB was used to test the mycobacterium tuberculosis early secretory antigentic target 6 （ESAT-6） in peripheral blood mononuclear cell and/or culture filtrate protein 10 （CFP-10） sensitized T cells. Then the results of T-SPOT ＂TB and the results of adenosine deaminase （ADA）, PPD skin test, polymerase chain reaction for pleural effusion myeobaeterium tuberculosis （TB-DNA） were compared. Results The accuracy of T-SPOT＇TB test was 92.05%, specificity was 92.31%, sensitivity was 92.00%, which were significantly better than those of ADA, PPD, TB-DNA test （P〈0.05）. Conclusion T-SPOT ＂TB test is suitable for diagnosis of tuberculous pleurisy, whose specificity, sensitivity and accuracy are significantly higher than other test methods, which is worthy of clinical application.