摘要
目的结核感染T细胞斑点试验(T-SPOT.TB)对结核性胸腔积液的诊断价值。方法分析2013年1月至2015年1月渗出性胸腔积液180例,评价T-SPOT.TB诊断效能,分析免疫状态对斑点数的影响。结果 T-SPOT.TB诊断渗出性胸腔积液敏感度为82.24%(88/107),特异度为72.60%(53/73)。T-SPOT.TB在免疫低下组和非免疫低下组敏感性分别为72.73%(40/55)、92.31%(48/52),特异性分别为52.63%(20/38)、94.29%(33/35),免疫低下组的诊断敏感度和特异度均显著低于非免疫低下组(P<0.05),免疫低下组ESAT-6和CFP-10的斑点形成细胞数显著低于非免疫低下组(Z值分别为-26.817,-43.756,P<0.05)。结论 T-SPOT.TB对结核性胸膜炎诊断的敏感度、特异度较好,具有重要的临床应用价值,在非免疫低下结核发病低危人群中的诊断价值优于免疫低下人群。
Objective To evaluate the clinical value of T-SPOT. TB in the diagnosis of tuberculous pleu- risy. Methods A total of 180 cases of hospitalized patients with pleural effusion （ hospitalized between January 2013 to January 2015 ） were enrolled. Efficiency of T-SPOT.TB in the diagnosis of tuberculosis was evaluated and the effects of immune state on the number of spot forming cells were analyzed. Results The sensitivity and speci- ficity of the T-SPOT.TB in diagnosis of tuberculous pleural effusion were 82.24 % （88/107） and 72.60 % （53/73）. The sensitivity and specificity of the T-SPOT.TB in immunocompromised patients were72.73% （40/55） and 52.63% （20/38）.The sensitivity and specificity of the T-SPOT.TB in non-immunocompromised were 92.31% （48/ 52） and 94.29% （33/35）.The sensitivity and specificity of those in non-immunocompromised were significantly higher than those in immunocompromised. ESAT-6 and CFP-10 specific SFCs of immunocompromised patients de- creased significantly compared with non-immunocompromised （Z is -26.817 and-43.756, P〈0.05 ）. Conclusion T-SPOT.TB has high sensitivity, specificity in the diagnosis of tuberculous pleurisy.T-SPOT.TB and is a promising clinical test in the diagnosis of non-immunocompromised with suspected TB, but its diagnostic performance in im- munocompromised patients is reduced compared with in non-immunoeompromised patients.
出处
《实用医学杂志》
CAS
北大核心
2017年第18期3119-3122,共4页
The Journal of Practical Medicine
基金
河南省医学科技攻关项目(编号:201503071)
