摘要
目的探讨噬菌体生物扩增法（PhaB）等多种方法诊断结核性胸膜炎的临床价值。方法选择150例胸腔积液患者，胸水分别行PhaB、腺苷脱氦酶（ADA）检测法、BACTECMGIT960培养法化验，并对检测结果进行比较。结果150例患者中诊断为结核性胸膜炎126例、恶性胸腔积液24例。经PhaB检测胸水阳性率46％、敏感度（又称真阳性率）51．58％，特异度83．33％，阳性预测值94．20％、阴性预测值24．69％；ADA法检测胸水阳性率32％、敏感度38．09％、特异度100％，阳性预测值100％、阴性预测值23．53％；BACTECMGIT960培养法检测胸水阳性率16．67％、敏感度19．84％、特异度100％，阳性预测值100％、阴性预测值19．20％。在确诊的126例结核性胸膜炎患者中，PhaB与ADA法及BACTECMGIT960培养法比较，差异均具统计学意义（P〈0．05），PhaB阳性率（即敏感度）明显高于ADA法和BACTECMGIT960培养法；将PhaB与ADA法相结合可提高检出的阳性率，为69．05％，均高于以上任意一种方法。结论噬菌体生物扩增法诊断结核性胸膜炎具有较高的敏感度和特异度，可作为结核性胸膜炎早期诊断的方法。
Objective To investigate the application value of phage amplified biologically assay and other methods to diagnose the tuberculous pleurisy. Methods In 150 cases of pleural effusion, pleural effusion were determined by PhaB method, adenosine deaminase （ADA） detection method, BACTEC MGIT960 rapid culture method, and the results were compared. Results 126 cases of tuberculous pleurisy and 24 cases of malignant pleural effusion were collected from 150 patients. By PhaB test,positive rate was 46%, sensitivity （also known as true positive rate） was 51.58.%, specificity was 83.33%, positive predictive value was 94.20%, negative predictive value was 24.69%; by ADA pleural fluid, positive rate was 32%, sensitivity was 38.09%, specificity was 100%, positive predictive value was 100%, negative predictive value was 23.53%; by BACTEC MGIT960 detection of pleural fluid culture, positive rate was 16.67%, sensitivity was 19.84%, specificity was 100%, positive predictive value was 100%, negative predictive value was 19.20%. In the 126 cases diagnosed in patients with tuberculous pleurisy, the positive rate （ie sensitivity） of PhaB was higher than BACTEC MGIT960 culture and the ADA test significantly （P〈0.05）. ADA combined with PhaB could increase the positive detection rate （69.05%）, higher than any of the above methods. conclusion The phage amplified biologically assay diagnosis of tuberculous pleurisy with high sensitivity and specificity could be used as early diagnosis of tuberculous pleurisy method.
出处
《中国实用乡村医生杂志》
2012年第24期34-36,共3页
Chinese Practical Journal of Rural Doctor
关键词
结核性胸膜炎
噬菌体生物扩增法
tuberculous pleurisy
phage amplified biological assay
