外周血与胸腔积液ELISPOT联合ADA检测诊断结核性胸膜炎的效果比较

摘要

Objective To compare the effects of pleural effusion and peripheral blood in enzyme linked immunosorbent assay( ELISPOT) combined with adenosine deaminase( ADA) detection for the diagnosis of tuberculous pleurisy.Methods The peripheral blood and pleural effusion specimens of 188 patients with pleurisy in Cangzhou Central Hospital from Jan.2013 to Jan.2014 were detected by ELISPOT detection and ADA testing.Pathological diagnosis by pleural effusion cytology,pleural biopsy or bronchoscopy biopsy was the gold standard.The spot forming cells(SFC) in peripheral blood and pleural effusion were recorded,and the diagnostic effects of ELISPOT detection and ADA testing using peripheral blood and pleural effusion were compared.Results The ELISPOT joint ADA test results showed that the SFC in the pleural effusion was higher than the peripheral blood, the sensitivity,specificity and accuracy of pleural effusion were 98.0%, 94.3%, 96.3%, which were significantly higher than the peripheral blood′s 90.0%, 88.6%, 89.4%respectively.Conclusion The pleural effusion for ELISPOT and ADA detection is more valuable than the peripheral blood in the diagnosis of tuberculosis.%目的：比较经外周血与胸腔积液酶联免疫斑点检测（ELISPOT）联合腺苷脱氢酶（ADA）检测法诊断结核性胸膜炎的效果。方法选取自2013年1月至2014年1月沧州市中心医院收治的188例胸膜炎患者。对所有患者的外周血、胸腔积液标本分别进行 ELISPOT检测、ADA检测。以胸腔积液脱落细胞检查、胸膜活检或纤维支气管镜活检病理证实为金标准。记录患者外周血及胸腔积液标本中斑点形成细胞数（SFC）的计数情况，比较不同途径 ELISPOT联合 ADA 检测的相关诊断指标。结果外周血与胸腔积液在ELISPOT联合ADA检测法诊断结核性胸膜炎的结果显示，胸腔积液中SFC高于外周血，胸腔积液诊断的灵敏度、特异度、准确度分别为98.0％、94.3％、96.3％，均高于外周血诊断的灵敏度、特异度、准确度（90.0％、88.6％、89.4％）。结论胸腔积液在 ELISPOT 与ADA联合检测法诊断结核性胸膜炎的价值较外周血高。