CAJ | 학술논문

目的：评价γ干扰素释放试验在结核性胸膜炎患者中的诊断价值。方法选取入住本院的116例可疑结核性胸膜炎( tuberculous pleurisy,TBP)患者,同时采集全血和胸水进行T-SPOT. TB检测,利用结核分枝杆菌特异性抗原ESAT-6和CFP-10与全血和胸水细胞共同培养,按说明判读检测结果。结果116例可疑结核性胸膜炎患者中有91例被确诊为活动性结核感染,25例排除结核感染。全血细胞诊断TBP的敏感性是79．1%,特异性是64．0%。胸水细胞诊断TBP的敏感性是90．1%,特异性是88．0%。两组患者比较T-SPOT. TB阳性率有显著差异(P<0．001)。联合全血和胸水细胞T-SPOT. TB结果阳性预测值等于100%(72/72),阴性预测值等于94．1%(16/17)。结论采集胸水细胞进行T-SPOT. TB 检测对诊断TBP具有可行性,联合全血和胸水进行T-SPOT. TB检测对于TBP的诊断意义会更大。
목적：평개γ간우소석방시험재결핵성흉막염환자중적진단개치。방법선취입주본원적116례가의결핵성흉막염( tuberculous pleurisy,TBP)환자,동시채집전혈화흉수진행T-SPOT. TB검측,이용결핵분지간균특이성항원ESAT-6화CFP-10여전혈화흉수세포공동배양,안설명판독검측결과。결과116례가의결핵성흉막염환자중유91례피학진위활동성결핵감염,25례배제결핵감염。전혈세포진단TBP적민감성시79．1%,특이성시64．0%。흉수세포진단TBP적민감성시90．1%,특이성시88．0%。량조환자비교T-SPOT. TB양성솔유현저차이(P<0．001)。연합전혈화흉수세포T-SPOT. TB결과양성예측치등우100%(72/72),음성예측치등우94．1%(16/17)。결론채집흉수세포진행T-SPOT. TB 검측대진단TBP구유가행성,연합전혈화흉수진행T-SPOT. TB검측대우TBP적진단의의회경대。
Objective To evaluate the diagnostic value of IGRA in patients with tuberculous pleural. Meth-ods 116 patients with suspected tuberculosis pleurisy were selected in this study, and their whole blood and pleural effusion were given T-SPOT. TB detection. PBMCs isolated from whole blood and pleural effusion were co-cultured with mycobacterium tuberculosis-specific antigens ESAT-6 and CFP-10, then the spots were counted which formed by specific T cells. Results 91 patients were diagnosed with active TB infection, and the other 25 patients were diag-nosed with non-TB infection. For diagnosing TBP, the sensitivity and specificity of PBMCs from whole blood were 79. 1% and 64. 0% respectively. The relative proportions with cells from pleural effusion were 90. 1% and 88. 0% re-spectively. The positive rate of T-SPOT. TB was significantly higher in the ATB group than in the non-TB group ( P<0. 001). The results of T-SPOT. TB combined whole blood PBMCs with pleural effusion cells had a positive predictive value of 100% (72/72) and a negative predictive value of 94. 1% (16/17). Conclusion T-SPOT. TB assay with pleural effusion cells can be used in the diagnosis of TBP, and the diagnostic value will be even greater while combi-ning with the IGRA results from whole blood and pleural fluid cells.