摘要
目的探讨胸腔积液结核杆菌感染T细胞斑点试验(T-SPOT.TB)和腺苷脱氨酶(ADA)检测对结核性胸膜炎的诊断价值。方法选取该院胸腔积液患者72例,分为临床确诊结核性胸膜炎组38例,非结核性胸膜炎组34例,进行胸腔积液T-SPOT.TB、胸腔积液ADA检测,评价两者诊断结核性胸膜炎的敏感度、特异度、预测值。结果 38例结核组胸腔积液组T-SPOT.TB检测阳性36例,胸腔积液ADA检测阳性30例,敏感度分别为94.7%,78.9%,差异有统计学意义(χ2=4.145,P=0.042)。34例非结核性胸膜炎组T-SPOT.TB检测阴性31例,胸腔积液ADA检测阴性33例,特异度分别为91.2%,97.0%,差异有统计学意义(P=0.614)。利用ROC曲线探讨胸腔积液T-SPOT.TB诊断结核性胸膜炎的最佳临界值为38 SFCs/106SEMC,ADA诊断结核性胸膜炎的最佳临界值为32.5 U/L。结论胸腔积液T-SPOT.TB检测是较准确地诊断结核性胸膜炎的方法。
Objective To investigate diagnostic value of the pleura1 effusion of Mycobacterium tuberculosis （MTB） T cell enzyme-linked immunospot tuberculous test （T-SPOT. TB） and adenosine deaminase （ADA） detection for the diagnosis of tuberculous pleurisy. Methods 72 patients with pleural fluid in Henan Provincial People＇s hospital were enrolled and categorized as clinical diagnosis of tuberculous pleurisy group （38 cases） and non-tuberculous pleurisy group （34 cases）. Pleural effusion T-SPOT. TB and ADA were measured and both of the diagnoses of tuberculous pleurisy in sensitivity, specificity, pre- dictive value were evaluated. Results Among 38 cases of tuberculous pleural effusion, 36 cases were positive for T-SPOT. TB while 30 cases were positive for ADA, the sensitivities of which were 94.7% and 78.9% respectively. The difference of the sensitivity was statistically significant（2 = 4. 145, P = 0. 042）. Among 34 cases of non-tuberculous pleural effusion, 31 cases were negative for T-SPOT. TB while 33 ca- ses were negative for ADA, the specificities of which were 91.2% and 97% respectively. The difference of the specificity was not statistically significant（P =0. 614）. The ROC curve was used to investigate the pleural effusion. The cutoff value of pleural T-SPOT. TB for tuberculous pleurisy was 38 SFCS / 106 SEMC while the cutoff value of pleural ADA for tuberculous pleurisy was 32.5U/L. Conclusion Pleural effusion T-SPOT. TB testing is a more accurate diagnosis for tuberculous pleurisy.
出处
《河南医学高等专科学校学报》
2015年第5期575-578,共4页
Journal of Henan Medical College
