结核感染T细胞斑点试验在老年结核性胸膜炎中的诊断价值  

T-SPOT.TB clinical value in the diagnosis of elderly patients with tuberculous pleurisy

作　　者：葛蓓蕾 王红[2] 张祥杰[1] 翟成凯[1] 曹臣龙[1] 李曼[1] 李红义[1] 沙正凯 Ge Beilei;Wang Hong;Zhang Xiangjie;Zhai Chengkai;Cao Chenlong;Li Man;Li Hongyi;Sha Zhengkai(Department of Respiratary Medicine,the First People′s Hospital of Xinxiang,Xinxiang 453000,China)

机构地区：[1]河南新乡市第一人民医院呼吸与危重症医学科,453000 [2]昆明医科大学第一附属医院老年科

出　　处：《中国临床保健杂志》2019年第3期423-425,共3页Chinese Journal of Clinical Healthcare

基　　金：河南省新乡市科技攻关计划(ZG15035)

摘　　要：目的探讨结核感染T细胞斑点试验(T-SPOT. TB)在老年结核性胸膜炎中的应用价值。方法选取老年渗出性胸腔积液患者72例,其中男性40例,女性32例;年龄范围60～84岁,年龄(70. 7±6. 04)岁。分别对72例老年渗出性胸腔积液患者进行胸水T-SPOT. TB、TB-DNA检测,最终分为老年结核性胸膜炎和非结核性胸膜炎,分别统计胸水T-SPOT. TB、TB-DNA的敏感性、特异性、阳性预测值、阴性预测值。结果临床诊断老年结核性胸膜炎42例,非结核性胸膜炎30例。胸水T-SPOT. TB敏感性85. 7%、特异性为93. 3%、阳性预测值94. 74%,阴性预测值82. 35%。TB-DNA敏感性73. 8%、特异性为100%、阳性预测值100%,阴性预测值73. 17%。老年结核性胸膜炎进行胸水TB-DNA检测也有较高的敏感性和特异性,但与胸水T-SPOT. TB相比,两者差异无统计学意义。结论老年结核性胸膜炎患者进行胸水T-SPOT. TB检测具有较高的敏感性和特异性,胸水T-SPOT. TB检测是诊断老年结核性胸膜炎的有效手段。Objective To research the tuberculous infection of T cells spot test(T-SPOT.TB)clinical value in the diagnosis of elderly patients with tuberculous pleurisy.Methods A total of 72 pleural effusion patients were collected.All patients with pleural effusion underwent T-SPOT.TB and TB-DNA test divided into tuberculous pleurisy group and non tuberculous pleurisy according to the final clinical diagnosis.The results were compared with final clinical diagnosis for sensitivity,specificity,positive predictive value,negative predictive,predictive value as evaluation target,discussed T-SPOT.TB applied value in the diagnosis of elderly patients with tuberculous pleurisy.Results Final diagnosis of 42 elderly patients with tuberculous pleurisy,30 patients with non tuberculous pleurisy.The T-SPOT.TB test results sensitivity,specificity,positive predictive value,negative predictive value were 85.7%,93.3%,94.7%,and 73.1% respectively.The sensitivity,specificity,positive predictive value,negative predictive value of TB-DNA test were 73.8%,100%,100%,and 73.17% respectively.Conclusion The sensitivity and specificity of pleural effusion T-SPOT.TB test for the diagnosis of elderly patients with tuberculous pleurisy is higher,the two methods have no significant statistical difference.

关 键 词：结核 胸膜 胸腔积液 酶联免疫斑点测定 

分 类 号：R521.7[医药卫生—内科学]