T-SPOT.TB技术检测胸腔积液在结核性胸膜炎诊断中的应用  

Application of T-SPOT.TB assay in tuberculous pleurisy diagnosis

作　　者：刘珍琼[1] 段永和 张齐龙[1] 叶琳[1] 边泽源[1] 

机构地区：[1]江西省胸科医院检验科,江西南昌330006

出　　处：《实验与检验医学》2013年第4期306-308,共3页Experimental and Laboratory Medicine

基　　金：江西省卫生厅课题(050314)

摘　　要：目的探讨结核分枝杆菌T细胞斑点试验(T-SPOT.TB)在临床快速诊断结核性胸膜炎及鉴别诊断中的应用价值。方法分别收集32例结核性胸膜炎患者和26例非结核性胸膜炎患者外周血和胸腔积液,采用T-SPOT.TB技术检测外周血和胸腔积液单个核细胞中的效应T细胞,比较二者诊断结核性胸膜炎的敏感性和特异性。结果胸腔积液T-SPOT.TB试验敏感性93.75%、特异性96.15%、阳性预测值96.77%、阴性预测值92.59%;外周血T-SPOT.TB试验敏感性81.25%、特异性92.30%、阳性预测值92.86%、阴性预测值80%。结论采用T-SPOT.TB技术检测外周血和胸腔积液中单个核细胞结核杆菌感染有助于提高结核性胸膜炎的诊断率,而且胸腔积液中单个核细胞T-SPOT.TB试验敏感性和特异性高于外周血。Objective To investigate the application value of Mycobacterium tuberculosis T cell enzyme-linked immunospot tuberculous test（T-SPOT.TB test） in tuberculous pleurisy（TBP） diagnosis and differential diagnosis.Methods Peripheral blood（PB） and pleural effusion（PE） samples were collected from 32 cases of TBM（case group） and 26 cases of non-TBP（control group） respectively.A spot test using T lymphocytes infected with Mycobacterium tuberculosis（T-SPOT.TB） was applied to detect the T lymphocytes in PB and PE samples.The sensitivity and specificity for diagnosing TBP by this method were evaluated.Results PE mononuclear cells T-SPOT.TB assay showed that the sensitivity and specificity were 93.75% and 96.15%;positive predictive value was 96.77%;negative predictive value was 92.59%.PB mononuclear cells T-SPOT.TB assay showed that the sensitivity and specificity were 81.25% and 92.30%;positive predictive value was 92.86%;negative predictive value was 80%.Conclusion PB and PE mononuclear cells T-SPOT.TB assays are favorable for the current diagnosis of TBP as auxiliary diagnostic methods,and PE mononuclear cells T-SPOT.TB assay is more efficient than PB assay.

关 键 词：T细胞斑点试验 结核性胸膜炎 胸腔积液 单个核细胞 

分 类 号：R446.19[医药卫生—诊断学] R378.911[医药卫生—临床医学]