γ-干扰素释放分析T-SPOT.TB在结核性胸腔积液中的诊断意义

目的 探讨γ-干扰素释放分析T-SPOT.TB的检测对结核性胸腔积液的诊断价值.方法 选取在本院住院的胸腔积液的患者78例,分为两组,每组患者39例,A组为疑是结核性胸腔积液,B组为临床确诊的癌性胸腔积液,两组患者均采用T-SPOT.TB试剂盒对外周血中释放γ-干扰素的结核分枝杆菌特异性T淋巴细胞进行检测,同时抽取胸水常规检测腺苷脱氨酶（ADA）及癌胚抗原（CEA）.结果 A组联合胸水常规ADA及 T-SPOT.TB检测结核性胸腔积液诊断敏感性高于单纯的ADA检测,差异有统计学意义（P〈0.05）,其CEA检测无明显升高,B组检测ADA 及T-SPOT.TB无升高情况.结论 联合胸水常规ADA及T-SPOT.TB检测对结核性胸腔积液诊断特异性高,对结核性疾病的诊断意义大,而对癌性胸腔积液无诊断意义.

Diagnostic value of interferon gamma release assaying T-SPOT.TB test in tuberculous pleural effusion.

Objective To investigate the diagnostic value of interferon gamma release assaying T-SPOT. TB test in patients with tuberculous pleural effusion. Methods 78 patients with pleural effusion were evenly divided into two groups, the group A with suspected tuberculous pleural effusion and the group B with confirmed malignant pleural effusion. The production of IFN-~/ secreting T-cells in pe- ripheral blood was detected by T-SPOT. TB test, and the levels of adenosine deaminase （ADA） and careinoembryonic antigen （CEA） in pleural fluid were also detected. Results In the group A, the sensitivity of the combined detection of ADA test and T-SPOT. TB test was obviously higher than ADA test only, and CEA test showed no significant increase. In the group B, there was no significant change of sen- sitivity by ADA and T-SPOT. TB method. Condusion The combined detection of ADA test and T-SPOT. TB test has a high sensitivity in the diagnosis of patients with tuberculous pleural effusion, but it has no significance in the diagnosis of malignant pleural effusion.