结核感染 T 细胞斑点试验和腺苷脱氨酶在结核性胸膜炎诊断中的临床应用价值

摘要

Objective To explore the joint detection of T -SPOT.TB and adenosine deaminase(ADA)in the diagnosis of tu-berculous pleurisy in clinical application.Method 86 patients with pleural effusion were recruited from the respiratoty wards in the Huaiyin Hospital,whose peripheral blood T -SPOT.TB and pleural effusion ADA were measured,and the sensitivity and spe-cificity were analyzed.Results According to the diagnostic criteria of tuberculous pleurisy,52 patients were diagnosed with tuber-culous pleurisy,34 were non -tuberculous pleurisy.The sensitivity of T -SPOT.TB for the diagnosis of tuberculous pleurisy was 90.3%(47 /52),the specificity was 88.2%(30 /34).The sensitivity of adenosine deaminase(ADA)for the diagnosis of tubercu-lous pleurisy was 80.2% (40 /52),the specificity was 85.2% (29 /34).The sensitivity of the combined detection of T -SPOT.TB and ADA was 94.2%,better than single detection(P <0.05).Conclusion Measurement of peripheral blood T -SPOT.TB and pleural effusion ADA for the diagnosis of tuberculous pleurisy have important clinical value,if the two joint detec-tion for the diagnosis of tuberculous pleurisy have more significance.%目的：探讨联合检测结核感染 T 细胞斑点试验（T －SPOT.TB）和腺苷脱氨酶（ADA）在结核性胸膜炎诊断中的临床应用价值。方法：收集淮阴医院呼吸科86例胸腔积液患者外周血和胸水标本，检测外周血 T －SPOT.TB 和胸水 ADA 水平，分析其对结核性胸膜炎诊断的灵敏度和特异度。结果：根据诊断及分组标准，最终诊断结核性胸膜炎52例，非结核性胸膜炎34例，外周血 T －SPOT.TB、胸水 ADA 诊断结核性胸膜炎的灵敏度分别是90.3％（47／52）、80.2％（40／52），特异度分别为88.2％（30／34）、85.2％（29／34）。2项指标联合检测结核性胸膜炎的灵敏度94.2％，均优于单项检测（P ＜0.05）。结论：测定患者外周血 T －SPOT.TB 和胸水 ADA 在结核性胸膜炎诊断中有较高的应用价值，两者联合检测对结核性胸膜炎诊断意义更大。