超声引导下胸膜活检联合胸腔积液检验对结核性胸膜炎的诊断价值  

Diagnostic value of ultrasound-guided pleural biopsy combined with pleural effusion examination for tuberculosis pleurisy

作　　者：刘文清 吴俊 马文斌 LIU Wenqing;WU Jun;MA Wenbin(Functional Examination Department,Guangzhou Chest Hospital,Guangzhou 510095,China)

机构地区：[1]广州市胸科医院功能检查科,广东广州510095

出　　处：《广州医药》2025年第4期505-508,536,共5页Guangzhou Medical Journal

基　　金：广州市医学重点学科(2021-2023)结核病学;广州市科技计划项目(2023A03J0539)。

摘　　要：目的探讨分析超声引导下胸膜活检(USPB)联合胸腔积液检验对于临床确诊结核性胸膜炎的应用价值。方法选取2021年6月—2023年6月广州市胸科医院收治的96例临床诊断为结核性胸膜炎(渗出性胸膜炎)的患者为研究对象,分别使用胸腔积液检验(包含胸腔积液腺苷脱氨酶及细菌培养)、USPB、两者联合三种方法诊断,计算其准确率、特异度及灵敏度并进行分析。结果胸腔积液诊断准确率73.96%、灵敏度72.84%,USPB诊断准确率为85.42%、灵敏度82.71%,两者联合诊断准确率为88.54%,灵敏度90.12%,较胸腔积液检验单独诊断准确率及灵敏度明显升高(P<0.05),胸腔积液、USPB、两者联合诊断特异度差异(P>0.05)无统计学意义。结论USPB联合胸腔积液检验对结核性胸膜炎的确诊具有较高临床价值。Objective To investigate the value of ultrasound-guided pleural biopsy(USPB)combined with pleural effusion test in the diagnosis of tuberculous pleurisy.Methods A total of 96 patients with tuberculous pleurisy(exudative pleurisy)admitted to the Guangzhou Chest Hospital from June 2021 to June 2023 were selected.The accuracy,specificity,and sensitivity of pleural effusion test(including adenosine deaminase and bacterial culture),USPB,and their combination were calculated and analyzed.Results The diagnostic accuracy of pleural effusion was 73.96%and the sensitivity was 72.84%.The diagnostic accuracy of USPB was 85.42%and the sensitivity was 82.71%.The diagnostic accuracy 88.54%and sensitivity 90.12%of USPB combined with pleural effusion test were significantly higher than that of pleural effusion alone(P<0.05),but there was no significant difference in the diagnostic specificity of pleural effusion,USPB and combination of them(P>0.05).Conclusions USPB combined with pleural effusion test has high clinical value in the diagnosis of tuberculous pleurisy.

关 键 词：结核性胸膜炎 胸膜活检 介入超声 胸腔积液 

分 类 号：R521[医药卫生—内科学]