胸腔积液X.DOT-TB试验对病原学阴性肺结核病的诊断价值  

Diagnostic Value of X.DOT-TB Test in Pleural Effusion for Pathogenic Negative Pulmonary Tuberculosis

作　　者：黄燊德 蒙是升 龙妍帆 邓海妃 陈诗敏 周绮琦 HUANG Shende;MENG Shisheng;LONG Yanfan;DENG Haifei;CHEN Shimin;ZHOU Qiqi(Jiangmen Tuberculosis Prevention And Control Institute,Jiangmen,Guangdong 529020)

机构地区：[1]江门市结核病防治所,广东江门529020

出　　处：《智慧健康》2023年第13期52-55,共4页Smart Healthcare

基　　金：江门市科技计划项目《胸腔积液T-SPOT试验对肺结核诊断价值的研究》(项目编号:2021YL05039)。

摘　　要：目的 探讨胸腔积液结核感染T细胞斑点试验(X.DOT-TB)在病原学阴性肺结核病的诊断价值。方法 选取2021年1月-2022年10月入住江门市结核病防治所的胸腔积液患者104例,其中结核病病原学阳性患者49例,病原学阴性患者55例,病原学阴性患者中经临床诊断为肺结核患者30例,非肺结核患者25例。对104例胸腔积液患者外周血及胸腔积液行X.DOT-TB检测和胸腔积液行腺苷脱氨酶(ADA)检测,并对测定结果进行分析比较。结果 病原学阴性肺结核患者胸腔积液X.DOT-TB敏感性为93.3%,特异性为80.0%,外周血和ADA的敏感性分别为70.0%和50.0%。三者中胸腔积液ADA特异性最高为95.8%。胸腔积液X.DOT-TB结果斑点数>100个的病例数显著高于外周血X.DOT-TB。结论 胸腔积液X.DOT-TB试验对结核病病原学阴性胸腔积液患者是首选的辅助诊断方法,联合ADA检测可提高肺结核检测特异性。Objective To investigate diagnostic value of T-cell spot test(X.DOT-TB)in etiology negative pulmonary tuberculosis.Methods The paper chose 104 patients with pleural effusion in Jiangmen City tuberculosis prevention and control center from January 2021 to October 2022,including 49 patients with tuberculosis etiology positive,55 patients with etiology negative,30 patients with pulmonary tuberculosis diagnosed clinically and 25 patients without pulmonary tuberculosis.104 patients with pleural effusion were tested for X.DOT-TB in peripheral blood and pleural effusion and adenosine deaminase(ADA)in pleural effusion.Related results were analyzed and compared.Results Sensitivity and specificity of X.DOT-TB in pleural effusion of patients with pathogenic negative pulmonary tuberculosis was 93.3%and 80.0%respectively.Sensitivity of peripheral blood and ADA was 70.0%and 50.0%respectively.Among the three,pleural effusion had the highest ADA specificity of 95.8%.Number of cases with pleural effusion X.DOT-TB results with more than 100 spots was significantly higher than peripheral blood X.DOT-TB.Conclusion X.DOT-TB test of pleural effusion is the first auxiliary diagnostic method for patients with tuberculosis aetiology negative pleural effusion,combination of ADA test can improve specificity of pulmonary tuberculosis detection.

关 键 词：胸腔积液X.DOT-TB Γ干扰素 病原学阴性 肺结核 

分 类 号：R521[医药卫生—内科学] R446.5[医药卫生—临床医学]