结核分枝杆菌T细胞斑点试验(T-SPOT.TB)技术在结核性胸膜炎诊断中的诊断价值

Diagnostic value of Mycobacterium tuberculosis T cell spot test(T-SPOT.TB) technique in the diagnosis of tuberculous pleurisy

目的:分析结核分枝杆菌T细胞斑点试验(T-SPOT.TB)技术在结核性胸膜炎诊断中的诊断价值。方法:对健康人群、结核性胸膜炎患者、非结核性胸膜炎患者、恶性胸腔积液患者进行T-SPOT.TB、腺苷脱氨酶(ADA)、结核抗体(TB-Ab)、痰涂片的检测,并对比分析检测结果。结果:结核组的T-SPOT.TB阳性率高于对照组、非结核组、恶性组,后三组比较差异无统计学意义。且ESAT-6和CFP-10结合检测的阳性率增高。T-SPOT.TB对于结核组总的敏感性为91.2%,总特异性为91.7%,总的准确率为91.4%,总的约登指数为0.829,相较单一抗原的指标均升高,相较于ADA和TB-Ab各项指标均增高,单一抗原比较,ESAT-6各项诊断指标均比CFP-10高。痰涂片的特异性非常高,达到了100%,但敏感性极低(8.8%)。结论:T-SPOT.TB是诊断结核性胸膜炎比较好的方法,检测敏感性和特异性均较高,值得推广。

Objective Analysis of My cobacterium tuberculosis T cell spot test(T-SPOT. TB) diagnostic value in the diagnosis of tuberculous pleurisy. Methods For healthy people, patients with tuberculous pleurisy, non tuberculous pleurisy and malignant pleural effusion in patients with T-SPOT. TB, adenosine deaminase(ADA), tuberculosis antibody(TB-Ab) detection, sputum smear, and comparative analysis of test results. Results The positive rate of T-SPOT. TB in tuberculosis group was higher than that in control group, non tuberculosis group and malignant group. There was no significant difference between the latter three groups. And the positive rate of ESAT-6 and CFP-10 combined detection increased. T-SPOT. TB for tuberculosis group total sensitivity was 91.2%, the overall specificity was 91.7%, the total accuracy rate was 91.4%, the total Youden index was 0.829, compared with the single antigen index were increased, compared with ADA and TB-Ab indexes were increased, compared the single antigen, ESAT-6 diagnosis index was higher than CFP-10. The specificity of sputum smear was very high, reached 100%, but the sensitivity was very low(88%). Conclusion T-SPOT. TB is a good method for diagnosis of tuberculous pleurisy, detection with high sensitivity and specificity, and is worthy of promotion.