结核感染T细胞斑点试验在结核性腹膜炎诊断中的临床应用

目的 探讨结核感染T细胞斑点试验(enzyme-linked immunospot assay in detection of mycobacterium tuberculosis infection,T-SPOT.TB)在临床诊断结核性腹膜炎中的应用价值.方法 对临床明确诊断结核性腹膜炎及可疑结核性腹膜炎患者(n=37)同时实施T-SPOT.TB、结核菌素试验(PPD)、结核抗体、血清腺苷脱胺酶(ADA)等检测,同时设非结核性腹膜炎患者为对照组(n=25).结果 利用T-SPOT.TB试验诊断结核性腹膜炎的阳性率为97.3％ (36/37),明显高于PPD的45.5％(15/33)、结核抗体检查的15.2％(5/33)、血清ADA的33.3％ (7/21),差异有统计学意义(P＜0.01).T-SPOT.TB试验诊断结核性腹膜炎的敏感性和特异性分别为97.3％和92.0％,显著高于PPD的45.5％和61.9％,差异有统计学意义(P＜0.01).结论 T-SPOT.TB酶联免疫斑点法是一种具有较高敏感性和特异性的检测结核感染的技术,对快速而准确地诊断结核性腹膜炎具有重要的临床应用价值.

Clinical value of T-SPOT.TB in diagnosis of tuberculous peritonitis

Objective To study the clinical application value of enzyme-linked immunospotassay in detection of mycobacterium tuberculosis infection（T-SPOT. TB） kit in the diagnosis of tuberculous peritonitis. Methods All blood samples were collected from final diagnosis or suspected tuberculous peritonitis patients（ n = 37） and non-tuberculous peritonitis patients（ n = 25）. The blood samples were detected by T-SPOT. TB, purified protein derivative（PPD）, anti- TB antibody test. Results T-SPOT. TB,PPD,anti-TB antibody test and the level of serum adenosine deaminase（ADA） were positive in 97.3% （36/37） ,45.5% （15/33）, 15.2% （5/33） and 33.3% （7/21）, respectively, in final diagnosis or suspected tuberculous peritonitis, T-SPOT. TB method was significantly higher than the other three methods （ P ,（ 0.01）. The sensitivity and specificity of T-SPOT. TB were 97.3% and 92.0%,which were significantly higher than those of PPD, 45.5 %, 61.9 % （ P （ 0.01 ） （ both P （ 0.05 ）. Conclusion T-SPOT. TB is a higher sensitivity and specificity technology to detect tuberculosis. And it is useful to diagnosis of tuberculous peritonitis quickly and accurately.