CAJ | 학술논문

目的：探讨胸腔积液结核杆菌感染 T 细胞斑点试验（T －SPOT．TB）和腺苷脱氨酶（ADA）检测对结核性胸膜炎的诊断价值。方法选取该院胸腔积液患者72例，分为临床确诊结核性胸膜炎组38例，非结核性胸膜炎组34例，进行胸腔积液 T －SPOT．TB、胸腔积液 ADA 检测，评价两者诊断结核性胸膜炎的敏感度、特异度、预测值。结果38例结核组胸腔积液组 T －SPOT．TB 检测阳性36例，胸腔积液 ADA 检测阳性30例，敏感度分别为94．7％，78．9％，差异有统计学意义（χ2＝4．145，P ＝0．042）。34例非结核性胸膜炎组 T －SPOT．TB 检测阴性31例，胸腔积液 ADA 检测阴性33例，特异度分别为91．2％，97．0％，差异有统计学意义（P ＝0．614）。利用 ROC 曲线探讨胸腔积液 T －SPOT．TB 诊断结核性胸膜炎的最佳临界值为38 SFCs／106 SEMC，ADA 诊断结核性胸膜炎的最佳临界值为32．5 U／L。结论胸腔积液 T －SPOT．TB 检测是较准确地诊断结核性胸膜炎的方法。
목적：탐토흉강적액결핵간균감염 T 세포반점시험（T －SPOT．TB）화선감탈안매（ADA）검측대결핵성흉막염적진단개치。방법선취해원흉강적액환자72례，분위림상학진결핵성흉막염조38례，비결핵성흉막염조34례，진행흉강적액 T －SPOT．TB、흉강적액 ADA 검측，평개량자진단결핵성흉막염적민감도、특이도、예측치。결과38례결핵조흉강적액조 T －SPOT．TB 검측양성36례，흉강적액 ADA 검측양성30례，민감도분별위94．7％，78．9％，차이유통계학의의（χ2＝4．145，P ＝0．042）。34례비결핵성흉막염조 T －SPOT．TB 검측음성31례，흉강적액 ADA 검측음성33례，특이도분별위91．2％，97．0％，차이유통계학의의（P ＝0．614）。이용 ROC 곡선탐토흉강적액 T －SPOT．TB 진단결핵성흉막염적최가림계치위38 SFCs／106 SEMC，ADA 진단결핵성흉막염적최가림계치위32．5 U／L。결론흉강적액 T －SPOT．TB 검측시교준학지진단결핵성흉막염적방법。
Objective To investigate diagnostic value of the pleural effusion of Mycobacterium tuber-culosis (MTB) T cell enzyme-linked immunospot tuberculous test (T-SPOT.TB) and adenosine deami-nase (ADA) detection for the diagnosis of tuberculous pleurisy.Methods 72 patients with pleural fluid in Henan Provincial People's hospital were enrolled and categorized as clinical diagnosis of tuberculous pleurisy group (38 cases) and non-tuberculous pleurisy group (34 cases).Pleural effusion T-SPOT.TB and ADA were measured and both of the diagnoses of tuberculous pleurisy in sensitivity, specificity, pre-dictive value were evaluated.Results Among 38 cases of tuberculous pleural effusion, 36 cases were positive for T-SPOT.TB while 30 cases were positive for ADA, the sensitivities of which were 94.7% and 78.9% respectively.The difference of the sensitivity was statistically significant(2 =4.145,P =0.042). Among 34 cases of non-tuberculous pleural effusion, 31 cases were negative for T-SPOT.TB while 33 ca-ses were negative for ADA, the specificities of which were 91.2% and 97% respectively.The difference of the specificity was not statistically significant(P =0.614).The ROC curve was used to investigate the pleural effusion.The cutoff value of pleural T-SPOT.TB for tuberculous pleurisy was 38 SFCS /106 SEMC while the cutoff value of pleural ADA for tuberculous pleurisy was 32.5U/L.Conclusion Pleural effusion T-SPOT.TB testing is a more accurate diagnosis for tuberculous pleurisy.