当代医学
噹代醫學
당대의학
CHINA CONTEMPORARY MEDICINE
2015年
15期
35-36
,共2页
结核感染T细胞斑点试验%结核性胸膜炎%结核抗体%胸水腺苷脱氨酶
結覈感染T細胞斑點試驗%結覈性胸膜炎%結覈抗體%胸水腺苷脫氨酶
결핵감염T세포반점시험%결핵성흉막염%결핵항체%흉수선감탈안매
T-SPOT.TB%Tuberculous pleurisy%Tuberculosis antibody%Ascitic adenosine deaminase
目的：评价结核感染T细胞斑点试验（T-SPOT.TB）对诊断结核性胸膜炎的价值。方法前瞻性纳入疑诊结核性胸膜炎患者100例，进行外周血T-SPOT.TB、血清结核抗体、胸腔积液腺苷脱氨酶（ADA）检测，并比较外周血T-SPOT.TB、胸腔积液ADA、血清结核抗体检测诊断结核性胸膜炎的灵敏度。外周血T-SPOT.TB、胸腔积液ADA、血清结核抗体检测诊断结核性胸膜炎的灵敏度分别为92.6%、95.5%、36.4%；特异度分别为92.3%、75%、76.8%；阳性预测值分别为96.2%、91.7%、57.1%，阴性预测值分别为85.7%、85.7%、35.5%。T-SPOT.TB特异度与后两种方法比较，差异均有统计学意义（均P<0.05）。灵敏度及阳性预测值、阴性预测值与胸水ADA比较，差异均无统计学意义；与血清结核抗体比较，差异均有统计学意义（均P<0.05）。结论 T-SPOT.TB对诊断结核性胸膜炎有较高的灵敏度及特异度，对临床应用有重要的参考价值。
目的：評價結覈感染T細胞斑點試驗（T-SPOT.TB）對診斷結覈性胸膜炎的價值。方法前瞻性納入疑診結覈性胸膜炎患者100例，進行外週血T-SPOT.TB、血清結覈抗體、胸腔積液腺苷脫氨酶（ADA）檢測，併比較外週血T-SPOT.TB、胸腔積液ADA、血清結覈抗體檢測診斷結覈性胸膜炎的靈敏度。外週血T-SPOT.TB、胸腔積液ADA、血清結覈抗體檢測診斷結覈性胸膜炎的靈敏度分彆為92.6%、95.5%、36.4%；特異度分彆為92.3%、75%、76.8%；暘性預測值分彆為96.2%、91.7%、57.1%，陰性預測值分彆為85.7%、85.7%、35.5%。T-SPOT.TB特異度與後兩種方法比較，差異均有統計學意義（均P<0.05）。靈敏度及暘性預測值、陰性預測值與胸水ADA比較，差異均無統計學意義；與血清結覈抗體比較，差異均有統計學意義（均P<0.05）。結論 T-SPOT.TB對診斷結覈性胸膜炎有較高的靈敏度及特異度，對臨床應用有重要的參攷價值。
목적：평개결핵감염T세포반점시험（T-SPOT.TB）대진단결핵성흉막염적개치。방법전첨성납입의진결핵성흉막염환자100례，진행외주혈T-SPOT.TB、혈청결핵항체、흉강적액선감탈안매（ADA）검측，병비교외주혈T-SPOT.TB、흉강적액ADA、혈청결핵항체검측진단결핵성흉막염적령민도。외주혈T-SPOT.TB、흉강적액ADA、혈청결핵항체검측진단결핵성흉막염적령민도분별위92.6%、95.5%、36.4%；특이도분별위92.3%、75%、76.8%；양성예측치분별위96.2%、91.7%、57.1%，음성예측치분별위85.7%、85.7%、35.5%。T-SPOT.TB특이도여후량충방법비교，차이균유통계학의의（균P<0.05）。령민도급양성예측치、음성예측치여흉수ADA비교，차이균무통계학의의；여혈청결핵항체비교，차이균유통계학의의（균P<0.05）。결론 T-SPOT.TB대진단결핵성흉막염유교고적령민도급특이도，대림상응용유중요적삼고개치。
Objective To evaluate the value of T-SPOT. TB (tuberculous pleurisy) in the diagnosis of tuberculous pleurisy.Methods A total of 50 patients with clinically suspected TBP admitted were enrolled in this prospective cohort study. Peripheral blood T-SPOT.TB, ascetic adenosine deaminase (ADA) and serum tuberculosis antibody (TB-Ab) were measured in the 100 patients and we compared the diagnostic value of the 3 methods.Results According to the standard of diagnosis of TBP and grouping, 54 patients were diagnosed with tuberculous pleurisy. The sensitivity of T-SPOT.TB for the diagnosis of tuberculous pleurisy was 92.6% (50/54), with statistical signiifcance when compared with serum TB-Ab 36.4% (16/44) (P<0.05), without statistical signiifcance when compared with ascitic ADA 95.5% (42/44). The speciifcity of T-SPOT.TB for the identiifcation of non-tuberculous pleurisy was 92.3% (24/26), with statistical significance when compared with serum TB-Ab 78.6% (22/28) and ascitic ADA 75% (12/16) (P<0.05). The positive prediction value of T-SPOT.TB for the diagnosis of tuberculous pleurisy was 96.2% (50/52), with statistical signiifcance when compared with serum TB-Ab 57.1% (8/14) (P<0.05), and without statistical signiifcance when compared with ascitic ADA 91.7% (44/48). The negative prediction value of T-SPOT.TB for the identiifcation of non-tuberculous pleurisy was 85.7% (24/28), with statistical signiifcance when compared with serum TB-Ab 35.5% (22/62), and ascetic ADA 85.7% (12/14) (P<0.05).Conclusion Peripheral blood T-SPOT. TB for the diagnosis of TBP is highly sensitive and speciifc, which is better than serum TB-Ab and ascitic ADA. T-SPOT.TB has an important reference for diagnosing suspected tuberculous pleurisy.
