摘要
目的评估胸腔积液内结核感染T细胞斑点检测(T cell enzyme-linked immunospot assay for tuberculosis,T-SPOT.TB)及腺苷脱氨酶(adenosine deaminase,ADA)对结核性胸膜炎(tuberculous pleurisy,TPE)的诊断价值。方法回顾性分析2017年6月至2020年6月河北省胸科医院收治的204例胸腔积液患者的临床资料,根据诊断结果分为结核组124例,非结核组80例,采用多因素logistic回归分析探讨T-SPOT.TB和ADA与TPE的关系;使用受试者工作特征(receiver operating characteristic,ROC)曲线确定胸腔积液中T-SPOT.TB及ADA诊断TPE的最佳临界值;用ROC曲线下面积(the area under the curve,AUC)、敏感度、特异度等指标评价T-SPOT.TB及ADA对TPE的诊断效能。结果多因素logistic回归分析结果显示胸腔积液T-SPOT.TB斑点数、ADA水平与TPE相关(OR=1.017,95%CI 1.011~1.023,P<0.05;OR=1.113,95%CI 1.065~1.163,P<0.05)。胸腔积液T-SPOT.TB与ADA诊断TPE的AUC分别为0.914、0.840。胸腔积液T-SPOT.TB与ADA诊断TPE的敏感度分别为80.6%(100/124)、58.1%(72/124),特异度分别为95.0%(76/80)、95.0%(76/80),胸腔积液T-SPOT.TB诊断TPE的敏感度显著高于ADA,差异有显著性(χ^(2)=14.874,P<0.05)。结论采用胸腔积液T-SPOT.TB诊断TPE具有较高的敏感度和特异度,其诊断效能优于ADA。
Objective To evaluate the value of Mycobacterium tuberculosis T cell spot test and ADA in the diagnosis of tuberculous pleurisy.Method 204 patients with pleural effusion diagnosed in Hebei Chest Hospital from June 2017 to June 2020 were retrospectively analyzed.There were 124 patients in tuberculosis group,80 patients in control group.Multivariate logistic regression analysis was used to explore the relationship between T-SPOT.TB,ADA and TPE.The receiver operating characteristic(ROC)curve was used to draw optimal critical value.The area under ROC curve was used to evaluate the diagnostic efficiency of tuberculous pleurisy.Result Multivariate logistic regression analysis showed that pleural effusion T-SPOT.TB and ADA were correlated with TPE(OR=1.017,95%CI 1.011-1.023,P<0.05;OR=1.113,95%CI 1.065-1.163,P<0.05).The AUC of T-SPOT.TB and ADA were 0.914 and 0.840 respectively.The sensitivity of T-SPOT.TB and ADA was 80.6%(100/124)and 58.1%(72/124),the specificity was 95%(76/80)and 95%(76/80)respectively.The sensitivity of diagnosis of tuberculous pleurisy T-SPOT.TB was significantly higher than ADA(χ^(2)=14.874,P<0.05).Conclusion In the diagnosis of tuberculous pleurisy,pleural effusion T-SPOT.TB is better than ADA.
作者
文玉琪
李志惠
任欣欣
崔丹
Wen Yuqi;Li Zhihui;Ren Xinxin;Cui Dan(Hebei University Affiliated Hospital/Clinical Medical College,Hebei Baoding 071000,China;Hebei Chest Hospital,Hebei Shijiazhuang 050041,China)
出处
《中国医刊》
CAS
2021年第7期732-735,共4页
Chinese Journal of Medicine
关键词
结核性胸膜炎
结核感染T细胞斑点检测
腺苷脱氨酶
Tuberculous pleurisy
T cell enzyme-linked immunospot assay for tuberculosis
Adenosine deaminase
