结核感染T细胞斑点试验、结核分枝杆菌核酸恒温扩增检测及腺苷脱氨酶联合检测在结核性胸腔积液诊断中的价值  

Value of tuberculosis infected T cells spot test,heated mycobacterium tuberculosis nucleic acid amplification testing,and adenosine deaminase in combined diagnosis of tuberculous pleural effusion

作　　者：郑歌 韩冉[1] 寿好长[1] 郑献民[2] 马子坤[1] ZHENG Ge;HAN Ran;SHOU Haochang;ZHENG Xianmin;MA Zikun(Department of Laboratory Medicine,Dongfang Hospital,Beijing University of Chinese Medicine,Beijing 100078,China;Department of Tuberculosis Internal Medicine,the First Affiliated Hospital of Xinxiang Medical University,Weihui 453100,Henan Province,China)

机构地区：[1]北京中医药大学东方医院检验科,北京100078 [2]新乡医学院第一附属医院结核内科,河南卫辉453100

出　　处：《新乡医学院学报》2024年第10期952-956,共5页Journal of Xinxiang Medical University

摘　　要：目的探讨结核感染T细胞斑点试验(T-SPOT.TB)、结核分枝杆菌核酸恒温扩增检测(TB-SAT)、腺苷脱氨酶(ADA)联合检测对结核性胸腔积液的诊断价值。方法选择2021年1月至2021年12月于新乡医学院第一附属医院就诊的135例胸腔积液患者为研究对象,其中结核性胸腔积液患者83例,非结核性胸腔积液患者52例。135例患者均进行外周血T-SPOT.TB、胸腔积液TB-SAT和胸腔积液ADA检测,比较3种方法单独检测和联合检测诊断结核性胸腔积液的灵敏度及特异度。结果T-SPOT.TB、TB-SAT、ADA单独检测诊断结核性胸腔积液的灵敏度、特异度比较差异均无统计学意义(P>0.05)。T-SPOT.TB+TB-SAT联合检测诊断结核性胸腔积液的灵敏度显著高于T-SPOT.TB、TB-SAT、ADA单独检测(χ^(2)=4.990、13.410、14.590,P<0.05);T-SPOT.TB+TB-SAT联合检测诊断结核性胸腔积液的特异度与T-SPOT.TB、TB-SAT、ADA单独检测比较差异均无统计学意义(χ^(2)=0.000、2.420、0.060,P>0.05)。T-SPOT.TB+ADA联合检测诊断结核性胸腔积液的灵敏度显著高于ADA单独检测(χ^(2)=4.069,P<0.05),与T-SPOT.TB、TB-SAT单独检测比较差异无统计学意义(χ^(2)=0.055、3.384,P>0.05)。T-SPOT.TB+ADA联合检测诊断结核性胸腔积液的特异度显著低于T-SPOT.TB、TB-SAT、ADA单独检测(χ^(2)=4.370、12.511、5.371,P<0.05)。TB-SAT+ADA联合检测诊断结核性胸腔积液的灵敏度与T-SPOT.TB、TB-SAT、ADA单独检测比较差异均无统计学意义(χ^(2)=0.000、2.604、3.213,P>0.05)。TB-SAT+ADA联合检测诊断结核性胸腔积液的特异度显著低于TB-SAT单独检测(χ^(2)=5.765,P<0.05),与T-SPOT.TB、ADA单独检测比较差异均无统计学意义(χ^(2)=0.782、1.251,P>0.05)。T-SPOT.TB+TB-SAT+ADA三者联合检测诊断结核性胸腔积液的灵敏度显著高于T-SPOT.TB、TB-SAT、ADA单独检测(χ^(2)=6.760、15.755、16.966,P<0.05);T-SPOT.TB+TB-SAT+ADA三者联合检测诊断结核性胸腔积液的特异度显著低于T-SPOT.TB、TB-Objective To explore the value of tuberculosis infected T cells spot test(T-SPOT.TB),heated mycobacterium tuberculosis nucleic acid amplification testing(TB-SAT),and adenosine deaminase(ADA)in diagnosing tuberculous pleural effusion.Methods A total of 135 patients with pleural effusion treated at the First Affiliated Hospital of Xinxiang Medical University from January 2021 to December 2021 were selected as the research subjects,including 83 patients with tuberculous pleural effusion and 52 patients with non-tuberculous pleural effusion.All these patients received peripheral blood T-SPOT.TB,chest water TB-SAT and chest water ADA tests,and the sensitivity and specificity of the above three methods in detecting tuberculous pleural effusion alone and in combination were compared.Results In terms of sensitivity and specificity,there was no statistically significant difference among the T-SPOT.TB,TB-SAT and ADA tests in detecting tuberculous pleural effusion alone(P>0.05).The sensitivity of the T-SPOT.TB+TB-SAT combined test in detecting tuberculous pleural effusion was significantly higher than that of the T-SPOT.TB,TB-SAT and ADA tests alone(χ^(2)=4.990,13.410,14.590;P<0.05),while the specificity of the T-SPOT.TB+TB-SAT combined test in detecting tuberculous pleural effusion showed no significant difference with that of the T-SPOT.TB,TB-SAT and ADA tests alone(χ^(2)=0.000,2.420,0.060;P>0.05).The sensitivity of the T-SPOT.TB+ADA combined test in detecting tuberculous pleural effusion was significantly higher than that of the ADA test alone(χ^(2)=4.069,P<0.05),but showed no significant difference with that of the T-SPOT.TB and TB-SAT tests alone(χ^(2)=0.055,3.384;P>0.05).The specificity of the T-SPOT.TB+ADA combined test in detecting tuberculous pleural effusion was significantly lower than that of the T-SPOT.TB,TB-SAT and ADA tests alone(χ^(2)=4.370,12.511,5.371;P<0.05).The sensitivity of the TB-SAT+ADA combined test in detecting tuberculous pleural effusion showed no significant difference with that of the T-SP

关 键 词：结核病 结核性胸腔积液 结核感染T细胞斑点试验 结核分枝杆菌核酸恒温扩增检测技术 腺苷脱氨酶 

分 类 号：R521.7[医药卫生—内科学]