结核感染T细胞斑点实验对结核性胸膜炎的诊断价值

摘要

Objective To explore the value of T-SPOT.TB test in the diagnosis of tuberculous pleurisy.Methods The positive rate,sensitivity,specificity,positive predictive value,and negative predictive value of T-SPOT.TB and ADA were calculated and compared.Among these patients,40 were retested by T-SPOT.TB after anti-tuberculosis treatment;and spot forming cells (SFCs) were compared before and after the treatment.Results The sensitivity,specificity,positive predictive value,and negative predictive value of T-SPOT.TB were 89.66％,86.54％,88.14％,88.24％,and 0.76.And those of ADA were 74.14％,75.00％,76.79％,72.22％,and 0.49.The sensitivity and specificity of T-SPOT.TB were significantly higher than those of ADA,with statistical differences (P＜0.05).40 patients were retested by the T-SPOT.TB after anti-TB treatment,and the results showed that ESAT-6 and CFP-10 specific SFCs decreased significantly compared with those before anti-TB treatment (P＜0.05).Conclusion T-SPOT.TB assay has an important clinical value in the diagnosis of tuberculous pleurisy and help us monitor treatment response.%目的 研究结核感染T细胞斑点实验(T-SPOT.TB)对结核性胸膜炎患者的诊断价值.方法 比较T-SPOT.TB、ADA检测110例渗出性胸腔积液患者的阳性率、灵敏度、特异度、阳性预测值、阴性预测值等;比较治疗前后T-SPOT.TB斑点数的变化.结果 T-SPOT.TB检测结核性胸膜炎患者的灵敏度、特异度、阳性预测值、阴性预测值、约登指数分别为89.66％、86.54％、88.14％、88.24％、0.76.ADA检测的灵敏度、特异度、阳性预测值、阴性预测值、约登指数分别为74.14％、75.00％、76.79％、72.22％、0.49.T-SPOT.TB的灵敏度、特异度明显高于ADA,差异有统计学意义(均P＜0.05).抗结核治疗后的结核性胸膜炎患者经ESAT-6和CFP-10刺激产生的斑点数明显低于抗结核治疗前(均P＜0.05).结论 T-SPOT.TB对结核性胸膜炎有较好的辅助诊断价值,在抗结核治疗效果监测方面有一定的指导意义.