摘要
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(P<0.05),后三组比较差异无统计学意义(P>0.05)。且早期分泌抗原靶蛋白(ESAT-6)和培养滤液蛋白10(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。痰涂片的特异性达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 To analyze the diagnostic value of Mycobacterium tuberculosis T cell spot test（T-SPOT.TB） in the diagnosis of tuberculous pleurisy. Methods T-SPOT.TB, adenosine deaminase（ADA）, tuberculosis antibody（TB-Ab） and sputum smear were detected in healthy people,tuberculous pleurisy, non tuberculous pleurisy and malignant pleural effusion, and the results were compared and analyzed. Results The positive rate of T-SPOT.TB in tuberculosis group was higher than that in control group, non tuberculosis group and malignant group（P〈0.05）. There was no significant difference between the latter three groups（P〉0.05）. The positive rate of the combination of ESAT-6 and CFP-10 was higher. 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 is very high, reaching 100%, but the sensitivity is very low（8.8%）. Conclusion T-SPOT.TB is a better method for the diagnosis of tuberculous pleurisy. The sensitivity and specificity of the detection are high. It is worth popularizing.
作者
段爱云
DUAN Ai-yun(Dongming County People＇s Hospital,laboratory of inspection,Heze City,Shandong 274500,China)
出处
《中国处方药》
2018年第5期7-8,共2页
Journal of China Prescription Drug
