外周血T-SPOT.TB与胸水T-SPOT.TB联合胸腔镜胸膜活检诊断结核性胸膜炎效果比较  

Efficacy comparison between thoracoscopic pleural biopsy combined with peripheral blood T-SPOT.TB and with pleural effusion T-SPOT.TB for diagnosis of tuberculous pleurisy

作　　者：梁丽萍[1] LIANG Liping(Jiangmen Central Hospital,Guangdong,Jiangmen 529030,China)

机构地区：[1]广东省江门市中心医院,广东江门529030

出　　处：《中国医药科学》2020年第11期123-125,133,共4页China Medicine And Pharmacy

基　　金：广东省江门市科技计划项目(2015002)。

摘　　要：目的对比分析胸腔积液T-SPOT.TB与外周血T-SPOT.TB试验联合胸腔镜胸膜活检诊断结核性胸膜炎的临床效果。方法回顾性分析2015年3月~2019年8月在江门市中心医院呼吸内科和感染科就诊的311例疑似结核性胸膜炎患者的临床资料,根据检查诊断方案不同进行分组,A组158例疑似患者采用胸腔镜胸膜活检联合胸腔积液T-SPOT.TB试验诊断,B组153例疑似者采用胸腔镜胸膜活检联合外周血T-SPOT.TB试验检测,比较两组诊断效果。结果A组的敏感度、诊断准确率以及阴性预测值较B组显著升高(P<0.05),而两组之间的特异性、阳性预测值差异无统计学意义(P>0.05)。结论胸水T-SPOT.TB联合胸腔镜胸膜活检诊断结核性胸膜炎的敏感度和准确率较高,可成为结核性胸膜炎早期诊断的首选方法。Objective To compare and analyze the clinical effect of thoracoscopic pleural biopsy combined with peripheral blood T-SPOT.TB and with pleural effusion T-SPOT.TB for diagnosis of tuberculous pleurisy.Methods The clinical data of 311 patients with suspected tuberculous pleurisy who were treated in the Department of Respiratory Medicine and Infectious Diseases of Jiangmen Central Hospital from March 2015 to August 2019 were retrospectively analyzed.They were divided into two groups according to the different diagnosis methods.The group A(n=158)was diagnosed by thoracoscopic pleural biopsy combined with pleural effusion T-SPOT.TB test.The group B(n=153)was diagnosed by thoracoscopic pleural biopsy combined with peripheral blood T-SPOT.TB test.The diagnosis efficacy of the two groups was compared.Results The sensitivity,diagnostic accuracy rateand negative predictive value of group A were significantly higher than those of group B(P<0.05),while there was no significant difference in specificity and positive predictive value between the two groups(P>0.05).Conclusion The pleural effusion T-SPOT.TB combined with thoracoscopic pleural biopsy has higher sensitivity and accuracy rate for the diagnosis of tuberculous pleurisy,which can be served as the preferred method for the early diagnosis of tuberculous pleurisy.

关 键 词：结核性胸膜炎 胸腔镜胸膜活检 胸水T-SPOT.TB试验 外周血T-SPOT.TB试验 

分 类 号：R526[医药卫生—内科学]