T-SPOT.TB在结核性心包炎中的诊断价值  

Diagnositic value of T-SPOT.TB for tuberculous pericarditis

作　　者：李杰[1] 张芝辉[1] 孔欣怡[2] 宋军福[1] 王雪梅[1] 舒维[1] 范励侦[1] 

机构地区：[1]江西省胸科医院,南昌市330006 [2]南昌大学第二附属医院,330006

出　　处：《实用医学杂志》2016年第21期3534-3536,共3页The Journal of Practical Medicine

基　　金：江西省卫计委科技计划项目(编号:20155513)

摘　　要：目的:研究结核感染T细胞斑点实验(T-SPOT.TB)在结核性心包炎中的诊断价值。方法:选取2012年5月至2016年7月江西省胸科医院收治的心包炎患者60例,分为结核性和非结核性心包炎两组,常规行外周血T-SPOT.TB检测,中量积液以上患者行心包积液T-SPOT.TB检测,对比两组患者T-SPOT.TB检测的差异。结果:在结核性心包炎组,心包积液的T-SPOT.TB特异及灵敏度分别达到了93.1%及90.3%,阳性和阴性预测值分别为93.3%和90%,较外周血有更好的诊断价值;抗原表达方面,结核性心包炎组ESAT-6及CFP-10较非结核性心包炎组有更高的表达值;在结核性心包炎组,合并活动性肺结核较未合并活动性肺结核患者T-SPOT.TB双抗原有更高的表达值,其中ESAT-6抗原表达强于CFP-10。结论:T-SPOT.TB对结核性心包炎有比较好的特异度和灵敏度,是一种有效的辅助诊断工具。Objective To investigate the diagnostic value of T lymphocytes spot test of tuberculosis （T- SPOT.TB） in tuberculous periearditis. Methods Sixty patients with pericarditis in Jiangxi Chest Hospital from May 2012 to July 2016 were enrolled in this study. The patients were divided into two groups： the tuberculous pericarditis group and the nontuberculous pericarditis group. The peripheral blood of each patient was used for detection of T-SPOT.TB. The pericardial effusion was also used for detection of T-SPOT.TB in patients with over medium pericardial effusion. Results In the tuberculous pericarditis group, the specificity and sensitivity of T- SPOT.TB peripheral blood were 93.1% and 90.3%, respectively; and the positive predictive value and negative predictive value were 93.3% and 90%, respectively. The diagnostic value of pericardial effusion was better than peripheral blood. In terms of antigen expression, ESAT-6 and CFP-10 in the tuberculous pericarditis group were higher than those in the nontuberculous pericarditis group. In the tuberculous periearditis group, the two antigen expression were higher in patients combined with active tuberculosis compared with patients not combined with active tuberculosis, and the expression of ESAT-6 was higher than CFP-10. Conclusions The T-SPOT.TB test has higher specificity and sensitivity and it can be used as an auxiliary diagnostic method for tuberculous pericarditis.

关 键 词：结核性心包炎 结核感染T细胞斑点实验 诊断 

分 类 号：R529.0[医药卫生—内科学]