T-SPOT.TB联合胸水CD64、S100A9、ADA检测诊断结核性胸腔积液的临床价值  

Clinical value of T-SPOT.TB combined with pleural fluid CD64,S100A9 and ADA in diagnosis of tuberculous pleural effusion

作　　者：李根 陶学萍 钟希 邓勇 欧书强 LI Gen;TAO Xue-ping;ZHONG Xi;DENG Yong;OU Shu-qiang(Second People's Hospital of Pingaiang CCity,Pingriang,Jiangri 337000,China)

机构地区：[1]萍乡市第二人民医院感染科,江西萍乡337000

出　　处：《中华医院感染学杂志》2025年第1期25-29,共5页Chinese Journal of Nosocomiology

基　　金：江西省卫生健康委科技计划(20204445)。

摘　　要：目的探究T细胞斑点试验(T-SPOT.TB)联合胸水中性粒细胞CD64、S100钙结合蛋白A9(S100A9)、腺苷脱氨酶(ADA)对结核性胸腔积液的诊断价值,提高对结核性胸腔积液患者的诊断准确性。方法选取2022年2月-2024年2月萍乡市第二人民医院收治的72例结核性胸腔积液患者为结核组,同期接受治疗的72例非结核性胸腔积液患者为非结核组,统计两组性别、年龄、基础性疾病等一般资料,比较两组患者血清T-SPOT.TB阳性率和胸水CD64、S100A9、ADA指标水平,受试者工作特征(ROC)曲线分析T-SPOT.TB联合CD64、S100A9、ADA检测诊断结核性胸腔积液的临床价值。结果结核组患者胸水CD64(3.34±0.47)%、S100A9(32.00±7.57)mg/ml及ADA(46.57±8.50)U/L表达水平均高于非结核组(P<0.05),血清T-SPOT.TB阳性率(77.22%)高于非结核组(22.22%)(P<0.05);ROC曲线显示T-SPOT.TB联合CD64、S100A9和ADA诊断结核性胸腔积液的曲线下面积(AUC)为0.945(95%CI:0.899~0.980),敏感度为98.61%,特异度为82.22%。结论结核性胸腔积液患者CD64、S100A9及ADA水平呈现升高趋势,可作为判断结核性胸腔积液的有效指标。且T-SPOT.TB联合CD64、S100A9及ADA检测的特异性与灵敏度较单一指标有所提升,可进一步提高诊断结核性胸腔积液的准确性。OBJECTIVE To explore the value of T-cell spot test(T-SPOT.TB)combined with pleural fluid neutrophil CD64,S100 calc-binding protein A9(S100A9)and adenosine deaminase(ADA)in diagnosis of tuberculous pleural effusion,so as to raise the accuracy of diagnosis of the patients with tuberculous pleural effusion.METHODS A total of 72 patients with tuberculous pleural effusion who were treated in Second People's Hospital of Pingxiang City from Feb.2022 to Feb.2024 were assigned as the tuberculous group,meanwhile,72 patients who had non-tuberculous pleural effusion were chosen as the non-tuberculous group.The baseline data of the two groups of patients,including gender,age and underlying diseases,were statistically analyzed.The positive rate of serum T-SPOT.TB and the levels of pleural effusion CD64,S1o0A9 and ADA were compared between the two groups of patients.The clinical value of T-SPOT.TB combined with CD64,S100A9 and ADA in diagnosis of the tuberculous pleural effusion was analyzed by means of receiver operating characteristic(ROC)curves.RESULTS The expression levels of pleural fluid CD64,S100A9 and ADA of the tuberculous group were(3.34±0.47)%,(32.00±7.57)mg/ml and(46.57±8.50)U/L,respectively,higher than those of the non-tuberculous group(P<0.05).The positive rate of serum T-SPOT.TB of the tuberculous group was 77.22%,higher than 22.22%of the non-tuberculous group(P<0.05).ROC curve analysis showed that the area under the curve(AUC)of the TSPOT.TB combined with CD64,S100A69 and ADA was 0.945(95%CI:0.899 to 0.980)in diagnosis of tuberculous pleural effusion,with the sensitivity 98.61%,the specificity 82.22%.CONCLUSIONS The patients with tuberculous pleural effusion show the upward trends of CD64,S100A9 and ADA,which can be used as effective indexes for diagnosis of tuberculous pleural effusion.The specificity and sensitivity of the joint detection of T-SPOT.TB,CD64,S100A9 and ADA are higher than those of the single detection,and the joint detection can further raise the accuracy of diagnosis of the tuberculous pleur

关 键 词：结核性胸腔积液 T细胞斑点试验 CD64 S100钙结合蛋白A9 腺苷脱氨酶 诊断价值 

分 类 号：R521[医药卫生—内科学]