中华实验和临床感染病杂志(电子版)
中華實驗和臨床感染病雜誌(電子版)
중화실험화림상감염병잡지(전자판)
CHINESE JOURNAL OF EXPERIMENTAL AND CLINICAL INFECTIOUS DISEASES(ELECTRONIC VERSION)
2014年
3期
391-395
,共5页
欧勤芳%高岩%邵凌云%郑建%刘袁媛%沈蕾%翁心华%张文宏
歐勤芳%高巖%邵凌雲%鄭建%劉袁媛%瀋蕾%翁心華%張文宏
구근방%고암%소릉운%정건%류원원%침뢰%옹심화%장문굉
结核%胸腔积液%全血γ-干扰素释放试验%胸膜活检%诊断
結覈%胸腔積液%全血γ-榦擾素釋放試驗%胸膜活檢%診斷
결핵%흉강적액%전혈γ-간우소석방시험%흉막활검%진단
Tuberculosis%Pleural effusion%Whole blood interferon-γ release assay%Pleural biopsy%Diagnosis
目的:评价全血γ-干扰素释放试验联合胸膜活检对结核性胸腔积液诊断的应用价值。方法应用全血γ-干扰素释放试验QuantiFERON-TB Gold In Tube(QFT-GIT)对79例胸腔积液患者进行检测,其中结核性胸腔积液患者45例,非结核性胸腔积液患者34例,结核合并肿瘤患者1例。同时,对其中27例患者进行胸腔镜下胸膜组织活检。结果结核性胸腔积液组,QFT-GIT的阳性率为91.1%(41/45),非结核性胸腔积液组的阳性率为26.5%(9/34)。QFT-GIT试验诊断结核性胸腔积液的敏感性为91.1%(41/45),特异性为73.5%(25/34),阳性预测值为82.0%,阴性预测值为89.3%;胸膜组织活检诊断结核性胸膜炎的敏感性为96.3%(26/27),特异性为100.0%(12/12)。联合胸膜活检诊断结核性胸膜炎的敏感性为95.5%(42/44),特异性为94.1%(32/34)。结论全血γ-干扰素释放试验QFT-GIT联合胸膜组织活检用于诊断结核性胸腔积液具有较高的敏感性和特异性,在我国具有较高的临床应用价值。
目的:評價全血γ-榦擾素釋放試驗聯閤胸膜活檢對結覈性胸腔積液診斷的應用價值。方法應用全血γ-榦擾素釋放試驗QuantiFERON-TB Gold In Tube(QFT-GIT)對79例胸腔積液患者進行檢測,其中結覈性胸腔積液患者45例,非結覈性胸腔積液患者34例,結覈閤併腫瘤患者1例。同時,對其中27例患者進行胸腔鏡下胸膜組織活檢。結果結覈性胸腔積液組,QFT-GIT的暘性率為91.1%(41/45),非結覈性胸腔積液組的暘性率為26.5%(9/34)。QFT-GIT試驗診斷結覈性胸腔積液的敏感性為91.1%(41/45),特異性為73.5%(25/34),暘性預測值為82.0%,陰性預測值為89.3%;胸膜組織活檢診斷結覈性胸膜炎的敏感性為96.3%(26/27),特異性為100.0%(12/12)。聯閤胸膜活檢診斷結覈性胸膜炎的敏感性為95.5%(42/44),特異性為94.1%(32/34)。結論全血γ-榦擾素釋放試驗QFT-GIT聯閤胸膜組織活檢用于診斷結覈性胸腔積液具有較高的敏感性和特異性,在我國具有較高的臨床應用價值。
목적:평개전혈γ-간우소석방시험연합흉막활검대결핵성흉강적액진단적응용개치。방법응용전혈γ-간우소석방시험QuantiFERON-TB Gold In Tube(QFT-GIT)대79례흉강적액환자진행검측,기중결핵성흉강적액환자45례,비결핵성흉강적액환자34례,결핵합병종류환자1례。동시,대기중27례환자진행흉강경하흉막조직활검。결과결핵성흉강적액조,QFT-GIT적양성솔위91.1%(41/45),비결핵성흉강적액조적양성솔위26.5%(9/34)。QFT-GIT시험진단결핵성흉강적액적민감성위91.1%(41/45),특이성위73.5%(25/34),양성예측치위82.0%,음성예측치위89.3%;흉막조직활검진단결핵성흉막염적민감성위96.3%(26/27),특이성위100.0%(12/12)。연합흉막활검진단결핵성흉막염적민감성위95.5%(42/44),특이성위94.1%(32/34)。결론전혈γ-간우소석방시험QFT-GIT연합흉막조직활검용우진단결핵성흉강적액구유교고적민감성화특이성,재아국구유교고적림상응용개치。
Objective To evaluate the diagnostic power of combined whole blood interferon-γrelease assay QuantiFERON-TB Gold In Tube (QFT-GIT) and pleural biopsy in tuberculous pleural effusion in China.Methods The whole blood interferon-γ release assay were measured by QFT-GIT test in 45 pleural tuberculosis patients and 34 non-tuberculous pleurisy controls. Among them, 27 patients received thoracoscopy and pleural biopsy.Results The positive rates of QFT-GIT in patients with tuberculous pleurisy and non-tuberculous pleurisy were 91.1% (41/45) and 26.5% (9/34), respectively. The sensitivity, speciifcity, positive predictive value and negative predictive value of QFT-GIT were 91.1% (41/45), 73.5%(25/34), 82.0% and 89.3%, respectively. The pleural biopsy assay applied to tuberculous pleurisy had 96.3%sensitivity and 100.0% speciifcity. Furthermore, combined QFT-GIT and pleural biopsy detection improved the speciifcity to 95.5% (42/44) with the sensitivity up to 94.1% (32/34).Conclusion The combination of immunoassay and biopsy has a promising prospect in the clinical practice of tuberculous pleurisy.