解放军医药杂志
解放軍醫藥雜誌
해방군의약잡지
MEDICAL&PHARMACEUTICAL JOURNAL OF CHINESE PEOPLE'S LIBERATION ARMY
2014年
8期
89-91,95
,共4页
胸腔积液%结核%γ-干扰素%T细胞斑点试验%腺苷脱氨酶%结核杆菌抗体%临床实验室技术
胸腔積液%結覈%γ-榦擾素%T細胞斑點試驗%腺苷脫氨酶%結覈桿菌抗體%臨床實驗室技術
흉강적액%결핵%γ-간우소%T세포반점시험%선감탈안매%결핵간균항체%림상실험실기술
Pleural effusion%Tuberculosis%Gamma interferon%T cell-spot test%Adenosine deaminase%Tuber-culosis antibody%Clinical laboratory technique
目的：探讨结核感染T细胞斑点试验( T-SPOT. TB)在结核性胸腔积液诊断中的意义。方法选取2011年6月-2013年12月解放军309医院收治的存在结核性胸腔积液的58例患者设为观察组,选择同期收治的存在非结核性胸腔积液的42例患者设为对照组。应用T-SPOT. TB试剂盒对纳入患者胸腔积液中的、经抗原刺激后释放γ-干扰素的效应T淋巴细胞即斑点形成细胞( SFC)的阳性率进行检测,同时行腺苷脱氨酶( ADA)、血清结核杆菌抗体( TB-AB)检测进行比较,对3种检测方法灵敏度、特异度、阳性预测值、阴性预测值以及诊断准确率进行比较。结果 T-SPOT. TB检测观察组SFC阳性率显著高于对照组(91.4% VS 7.14%；χ2=71.2,P<0.01)；对结核性胸腔积液的诊断灵敏度、特异度、阳性预测值、阴性预测值及诊断准确率应用T-SPOT. TB检测均显著高于ADA和TB-AB检测(P<0.05),除特异度外,ADA检测均显著高于TB-AB检测(P<0.05)。结论应用T-SPOT. TB检测胸腔积液中释放γ-干扰素的特异性T细胞数量对诊断结核性胸腔积液具有较高的灵敏度,可作为辅助诊断方法,联合应用ADA或TB-AB检测可提高鉴别诊断率。
目的：探討結覈感染T細胞斑點試驗( T-SPOT. TB)在結覈性胸腔積液診斷中的意義。方法選取2011年6月-2013年12月解放軍309醫院收治的存在結覈性胸腔積液的58例患者設為觀察組,選擇同期收治的存在非結覈性胸腔積液的42例患者設為對照組。應用T-SPOT. TB試劑盒對納入患者胸腔積液中的、經抗原刺激後釋放γ-榦擾素的效應T淋巴細胞即斑點形成細胞( SFC)的暘性率進行檢測,同時行腺苷脫氨酶( ADA)、血清結覈桿菌抗體( TB-AB)檢測進行比較,對3種檢測方法靈敏度、特異度、暘性預測值、陰性預測值以及診斷準確率進行比較。結果 T-SPOT. TB檢測觀察組SFC暘性率顯著高于對照組(91.4% VS 7.14%；χ2=71.2,P<0.01)；對結覈性胸腔積液的診斷靈敏度、特異度、暘性預測值、陰性預測值及診斷準確率應用T-SPOT. TB檢測均顯著高于ADA和TB-AB檢測(P<0.05),除特異度外,ADA檢測均顯著高于TB-AB檢測(P<0.05)。結論應用T-SPOT. TB檢測胸腔積液中釋放γ-榦擾素的特異性T細胞數量對診斷結覈性胸腔積液具有較高的靈敏度,可作為輔助診斷方法,聯閤應用ADA或TB-AB檢測可提高鑒彆診斷率。
목적：탐토결핵감염T세포반점시험( T-SPOT. TB)재결핵성흉강적액진단중적의의。방법선취2011년6월-2013년12월해방군309의원수치적존재결핵성흉강적액적58례환자설위관찰조,선택동기수치적존재비결핵성흉강적액적42례환자설위대조조。응용T-SPOT. TB시제합대납입환자흉강적액중적、경항원자격후석방γ-간우소적효응T림파세포즉반점형성세포( SFC)적양성솔진행검측,동시행선감탈안매( ADA)、혈청결핵간균항체( TB-AB)검측진행비교,대3충검측방법령민도、특이도、양성예측치、음성예측치이급진단준학솔진행비교。결과 T-SPOT. TB검측관찰조SFC양성솔현저고우대조조(91.4% VS 7.14%；χ2=71.2,P<0.01)；대결핵성흉강적액적진단령민도、특이도、양성예측치、음성예측치급진단준학솔응용T-SPOT. TB검측균현저고우ADA화TB-AB검측(P<0.05),제특이도외,ADA검측균현저고우TB-AB검측(P<0.05)。결론응용T-SPOT. TB검측흉강적액중석방γ-간우소적특이성T세포수량대진단결핵성흉강적액구유교고적령민도,가작위보조진단방법,연합응용ADA혹TB-AB검측가제고감별진단솔。
Objective To explore the significance of tuberculosis infection T cell-spot test for tuberculosis infec-tion ( T-SPOT. TB) in diagnosis of tuberculous pleural effusion. Methods A total of 58 inpatients with tuberculous pleu-ral effusion ( observation group) during June 2011 and December 2013 and 42 inpatients without tuberculous pleural effu-sion ( control group) at the same time were selected. Positive rate of effector T lymphocytes ( spots formation, SFC) re-leasing gamma interferon after antigenic stimulation in pleural effusion of the patients was detected by T-SPOT. TB reagent kit, and the Adenosine Deaminase ( ADA) and serum mycobacterium tuberculosis antibody ( TB-AB) examinations were also performed, and then values of sensitivity, specificity, positive predictive value, negative predictive value and the di-agnostic accuracy by the three kinds of methods were compared. Results SFC positive rate of T-SPOT. TB in observation group was significantly higher than that in control group (91. 4% VS 7. 14%;χ2 =71. 2, P<0. 01);values of sensitivi-ty, specificity, positive predictive value, negative predictive value and the diagnostic accuracy by T-SPOT. TB were sig-nificantly higher than those by ADA and TB-AB examinations ( P<0. 05 ) , while the values by ADA examination were significantly higher than those by TB-AB examination, except for the specificity value ( P <0. 05 ) . Conclusion T-SPOT. TB in detection of the specificity T cell numbers releasing γ-interferon in pleural effusion has higher sensitivity in diagnosis of tuberculous pleural effusion, and can be used as an auxiliary diagnostic method. T-SPOT. TB combined with ADA or TB-AB examination may improve the differential diagnosis rate.
