结核感染T细胞斑点试验联合腺苷脱氨酶在结核性胸膜炎中的诊断价值  

The diagnostic value of tuberculous infection T-cell spot test combined with adenosine deaminase in tuberculous pleurisy

作　　者：师卫[1] 米亚沙尔·塔拉提 李爱英[1] 王淑梅[1] SHI Wei;MIYASHAR Talati;LI Aiying;WANG Shumei(Internal Medicine Department Tacheng District People's Hospital of Xinjiang,Tacheng 834700,China)

机构地区：[1]新疆塔城地区人民医院内科,新疆塔城834700

出　　处：《黑龙江医药科学》2025年第2期62-64,共3页Heilongjiang Medicine and Pharmacy

基　　金：新疆塔城科技计划项目,编号:2022023。

摘　　要：目的:对比分析结核感染T细胞斑点试验(T-SPOT.TB)联合胸水腺苷脱氨酶(adenosine deaminase,ADA),诊断结核性胸膜炎中的临床效果。方法:选取2021年1月至2023年12月在新疆塔城地区人民医院住院的胸腔积液患者179例为研究对象,其中89例为确诊结核性胸膜炎患者(观察组),90例为心源性积液、炎性积液及癌性积液患者(对照组),所有患者均应用血T-SPOT.TB检测及胸水ADA检测,对比敏感度、特异度、阳性预测值、阴性预测值。绘制ROC曲线,评估两种检测方法的准确度。结果:结核性胸膜炎组,血T-SPOT.TB敏感度为84.3%,胸水ADA敏感度为97.8%。非结核性胸膜炎组,血T-SPOT.TB特异度为90.0%,胸水ADA特异度为52.2%。两组患者并联检测的敏感度为98.9%,串联检测的特异度为95.6%。阳性预测值:血T-SPOT.TB为89.3%、ADA为66.9%;阴性预测值:血T-SPOT.TB为84.2%、ADA为95.9%。ROC曲线面积下,胸水ADA为0.95,血T-SPOT.TB为0.86。结论:血T-SPOT.TB联合胸水ADA在结核性胸膜炎的诊断中具有应用价值。Objective:To compare the diagnostic efficacy of the combined tuberculin infection T-cell spot test(T-SPOT.TB)with pleural fluid adenosine deaminase(ADA)for diagnosing tuberculous pleurisy.Methods:179 patients with pleural effusion who were hospitalized at the People's Hospital of Tacheng Prefecture,Xinjiang,from January 2021 to December 2023 were choosed.Among them,89 patients were diagnosed with tuberculous pleural effusion(observation group),and 90 patients had cardiogenic effusion,inflammatory effusion and cancerous effusion(control group).All patients underwent blood T-SPOT.TB testing and pleural fluid ADA testing.Sensitivity,specificity,positive predictive value and negative predictive value were compared between the two tests.ROC curves were plotted to assess the accuracy of the two detection methods.Results:The sensitivity of blood T-SPOT.TB for tuberculous pleurisy was 84.3%,and that of pleural fluid ADA was 97.8%.The specificity of blood T-SPOT.TB for non-tuberculous pleurisy was 90.0%,while that of pleural fluid ADA was 52.2%.The parallel detection sensitivity for both groups was 98.9%,and the serial detection specificity was 95.6%.Positive predictive value:Blood T-SPOT.TB at 89.3%,ADA at 66.9%;Negative predictive value:Blood T-SPOT.TB at 84.2%,ADA at 95.9%.The AUC of the ROC curve for pleural fluid ADA is 0.95,and that for blood T-SPOT.TB is 0.86.Conclusion:The combination of blood T-SPOT.TB and pleural fluid ADA holds diagnostic value in tuberculous pleurisy.

关 键 词：结核感染T细胞斑点试验 腺苷脱氨酶 结核性胸膜炎 

分 类 号：R446[医药卫生—诊断学]