T细胞斑点试验、腺苷脱氨酶及降钙素原在结核性胸膜炎诊断中的应用  

The value of T-cell spot test,adenosine deaminase and procalcitonin in the diagnosis of tuberculous pleurisy

作　　者：杨晓闪 张庆宪[1] Yang Xiaoshan;Zhang Qingxian(Department of Respiratory Medicine, the First Affiliated Hospital of Zhengzhou Zhengzhou 450052, Chin)

机构地区：[1]郑州大学第一附属医院呼吸内科,河南郑州450052

出　　处：《河南医学研究》2018年第8期1379-1382,共4页Henan Medical Research

摘　　要：目的探讨结核感染T细胞斑点试验(T-SPOT.TB)、胸水腺苷脱氨酶(ADA)及血清降钙素原(PCT)在结核性胸膜炎诊断中的应用价值。方法选取2016年1—12月郑州大学第一附属医院收治的112例行胸腔穿刺的胸腔积液患者,根据诊断结果分为结核组(结核性胸膜炎患者61例)和对照组(非结核性胸膜炎患者51例),检测两组T-SPOT.TB、胸水ADA及血清PCT水平,对比3项指标单独、并联和串联检测诊断结核性胸膜炎的灵敏度和特异度。结果结核组T-SPOT.TB的阳性率、ADA及PCT水平均高于对照组,差异有统计学意义(均P<0.05);T-SPOT.TB、ADA、PCT诊断结核性胸膜炎的灵敏度分别为90.2%、91.8%和50.8%,特异度分别为80.4%、88.2%和82.4%。3项指标并联检测的灵敏度高于串联检测(96.7%比56.9%),特异度低于串联检测(42.6%比100%),差异有统计学意义(均P<0.05)。结论外周血T-SPOT.TB、胸水ADA及血清PCT3项指标联合检测比单独检测的诊断价值高,有利于结核性胸膜炎的早期诊断及治疗。Objective To explore the clinical value of the t-spot test tuberculosis（T-SPOT. TB）,adenosine deaminase（ADA） of hydrothorax and procalcitonin（PCT） in serumon tuberculous pleurisy. Methods One hundred and twelve patients with pleural effusion admitted to the First Affiliated Hospital of Zhengzhou University from January to December in 2016 were selected and divided into tuberculosis group（61 patients with tuberculous pleurisy） and control group（51 patients with non-tuberculous pleural effusion） according to the diagnosis. In 112 patients,two groups of T-SPOT. TB,pleural fluid ADA,and serum PCT levels were detected. The sensitivity and specificity of three separate indicators for the diagnosis of tuberculous pleurisy were tested in parallel and in tandem. Results The positive rate of T-SPOT. TB and the levels of ADA and PCT in tuberculosis group were higher than those in control group,and the differences were statistically significant（P〈0. 05）. The sensitivities of T-SPOT. TB,ADA and PCT in the diagnosis of tuberculous pleurisy were respectively 90. 2%,91. 8%,and 50. 8%,and the specificities were 80. 4%,88. 2%,and 82. 4%,respectively. The sensitivity of parallel detection of three indicators was higher than that of tandem test（96. 7% versus 56. 9%）,and the specificity was lower than that of tandem test（42. 6% versus100%）. The differences were statistically significant（P〈0. 05）. Conclusion The combined detection of T-SPOT. TB,ADA of hydrothorax and PCT in serum is more valuable than that of single detection,which is helpful to the early diagnosis and treatment of tuberculous pleurisy.

关 键 词：结核性胸膜炎 T细胞斑点试验 结核分枝杆菌 腺苷脱氨酶 降钙素原 诊断 

分 类 号：R561.1[医药卫生—呼吸系统]