斑点免疫金渗滤法检测胸水抗PPD-IgG对结核性胸腔积液的诊断价值

目的　评价胸水抗PPD IgG检测对结核性胸腔积液的诊断价值。方法　采用斑点免疫金渗滤试验 (DIGFA)检测 14 0例结核性胸腔积液患者 (结核组 )和 62例非结核性胸腔积液患者 (对照组 )的胸水和血清抗PPD IgG ,同时取胸水进行结核分支杆菌涂片和培养检查 ,并对它们的阳性率进行比较。结果　结核性胸腔积液患者胸水、血清抗PPD IgG阳性率分别为 78.6% ,69.3 % ,与胸水结核分支杆菌涂片阳性率 (5 .0 % ) ,胸水结核分支杆菌培养阳性率 (2 2 .9% )比较 ,有显著性差异 (P <0 .0 1) ;与对照组胸水、血清抗PPD IgG阳性率 (8.1% ,11.2 % )比较 ,有显著性差异 (P <0 .0 1)。结核性胸腔积液患者胸水与血清的抗PPD IgG阳性率比较 ,无显著性差异 (P >0 .0 5 ) ,但胸水抗PPD IgG阳性率比血清高出 9.3 %。DIGFA法测定胸水抗PPD IgG的敏感性为 78.6% ,特异性为 91.9% ,准确性为 82 .7%。血清抗PPD IgG的敏感性为 69.3 % ,特异性为 88.8% ,准确性为 75 .2 %。结论　用DIGFA法检测胸水抗PPD IgG具有操作简单、快速 ,不需特殊设备 ,且敏感性好和特异性高 ,对结核性胸腔积液具有较高的临床辅助诊断价值。

The diagnostic value of detection of Anti-PPD-IgG in pleural effusion for tuberculous pleural effusion by dot-immunogold filtration assay

Objective To evaluate the diagnostic value of Anti-PPD-IgG in pleural effusion for the tuberculous pleural effusion.Methods Anti-PPD-IgG in pleural and serum effusion were detected in 140 cases of tuberculous pleural effusion and 62 cases of non-tuberculous pleural effusion by dot-immunogold filtration assay (DIGFA) while comparing with the positive rate of Mycobacterium tuberculosis in pleural effusion of these cases.Results The positive rate of Anti-PPD-IgG in pleural (78.6%) and serum effusion (69.3%) in tuberculous pleural effusion group were higher than that of Mycobacterium tuberculosis smear (5.0%,P <0.01) and Mycobacterium tuberculosis (22.9%,P <0.01) and also higher than those of Anti-PPD-IgG in pleural (8.1%,P <0.01) and serum effusion (11.2%,P <0.01) of the control group.There were no significant differences in the postive rate of Anti-PPD-IgG between plerural and serum effusion in cases of tuberculous pleural effusion ( P >0.05).The sensityvity,specificity and accuracy of Anti-PPD-IgG in pleural and serum effusion to diagnose the tuberculous pleural effusion were 78.6%,91.9%,82.7%and,88.8%,75.2%,respectively.Conclusion DIGFA is a rapid,simple,specific and sensitive method for detection of Anti-PPD-IgG in pleural effusion,it is useful for diagnosis of tuberculous pleural effusion.