摘要
[目的]探讨腺苷脱氨酶(adenosine deaminase,ADA)、乳酸脱氢酶(lactate dehydrogenase,LDH)水平以及外周血结核感染T淋巴细胞酶联免疫斑点试验(T-SPOT.TB)对结核性胸膜炎的诊断价值。[方法]回顾性分析40例结核性胸膜炎患者和48例非结核性胸膜炎患者的外周血T-SPOT.TB检测值和胸腔积液的ADA、LDH水平,分析三者的受试者工作特征曲线(receiver operating characteristic curve,ROC)。[结果]非结核性胸膜炎组患者ADA、LDH、TSPOT.TB和三项联合检测所得阳性率均远低于结核性胸膜炎组患者,差异有统计学意义(P <0.01);结核性胸膜炎组患者中,三项联合检测的阳性率最高,达95.0%。非结核性胸膜炎组四类检测方法所得阳性率差异有统计学意义(P <0.01),其中三项联合检测所得阳性率仅有2.08%(1例)。结核性胸膜炎组胸腔积液中LDH水平、ADA水平中位数均高于非结核性胸膜炎组,差异有统计学意义(P <0.01);ADA和T-SPOT.TB对应的ROC曲线下面积等大,且大于LDH对应面积;T-SPOT.TB的ROC曲线最靠近左上角;诊断结核性胸腔积液特异度依次为:T-SPOT.TB> ADA> LDH,灵敏度依次为:ADA> T-SPOT.TB> LDH。[结论] TSPOT.TB、ADA和LDH检测对结核性胸膜炎的快速诊断具有重要的临床价值,又以T-SPOT.TB诊断效能最优。
[Objective]To investigate the efficiency of peripheral blood tuberculosis infection T cell spot test(T-SPOT.TB),adenosine deaminase(ADA)and lactate dehydrogenase(LDH)activity of pleural effusion for tuberculous pleurisy.[Methods]The receiver operating characteristic(ROC)curve was used to analyze the examination results of ADA and LDH of pleural effusion and T-SPOT.TB in peripheral blood in both 40 patients with tuberculous pleurisy and 48 patients with non-tuberculous pleurisy.[Results]The positive rates of ADA,LDH,TSPOT.TB and three combined tests in patients with non-tuberculous pleurisy were significantly lower than those of patients with tuberculous pleurisy(P<0.01).Among patients with tuberculous pleurisy,the positive rate of combined three indicators was the highest(95.0%).The positive rates of these indicators among patients with non-tuberculous pleurisy varied statistically(P<0.01),and only 1 patient(2.0%)had positive rate for all combined 3 indicators.The medians of LDH and ADA levels in pleural effusion of patients with tuberculous pleurisy were higher than those in the patients with non-tuberculous pleurisy(P<0.01).The area of ADA under the ROC curve was equal to that of T-SPOT.TB,and was larger than that of LDH;the ROC curve of T-SPOT.TB was the closest to the top left.For diagnosis of tuberculous pleural effusion,the order of specificity was T-SPOT.TB>ADA>LDH,and the order of sensitivity was ADA>TSPOT.TB>LDH.[Conclusion]T-SPOT.TB,ADA and LDH test had important clinical value in the rapid diagnosis of tuberculous pleurisy,and the clinical value of T-SPOT.TB was the best.
作者
章静
陆雪儿
赵盼
陈葆春
ZHANG Jing;LU Xue’er;ZHAO Pan;CHEN Baochun(Prevention and Treatment Center for Occupational Disease,Anhui Second Provincial People’s Hospital,Hefei,Anhui 230022,China;School of Medicine,Anhui University of Science and Technology,Huainan,Anhui 232002,China)
出处
《职业卫生与应急救援》
2019年第2期126-129,共4页
Occupational Health and Emergency Rescue
基金
安徽省教育厅科研项目(12925KJ2018B12)
安徽省卫计委科研项目(2018SEYL004)
作者简介
章静(1975—),女,硕士,副主任技师.
