胸腔积液与外周血 ELISPOT 检测诊断结核性胸膜炎的#br# 效果比较

目的 通过比较不同途径的酶联免疫斑点（ELISPOT）检测， 探讨其对结核性胸膜炎的诊断价值。方法 采用 T-Spot-TB 试剂盒对 164 例结核性胸腔积液和 102 例非结核性胸腔积液患者的外周血和胸腔积液标本进行检测。比较两组的斑点形成细胞数 （SFC）， 采用诊断试验比较胸腔积液与外周血 ELISPOT 检测诊断结核性胸膜炎的灵敏度及特异度。结果 胸腔积液与外周血 ELISPOT 检测的受试者工作特征曲线下面积分别为 0.947 和 0.905； 胸腔积液 ELISPOT 检测诊断结核性胸膜炎的灵敏度（95.1%）高于外周血（89.0%）； 特异度（90.2%）也高于外周血（88.2%）。结论 胸腔积液较外周血 ELISPOT检测具有更高的诊断结核性胸膜炎的价值。

Comparison of effects of ELISPOTs using pleural fluid and peripheral blood in the diagnosis of#br# tuberculous pleurisy

Objective To evaluate the effects of ELISPOT (enzyme-link immunospot) test using different samples in diagnosing tuberculous pleurisy. Methods Using T-Spot-TB kit to detect interferon-γ level in pleural effusion and peripheral blood from 164 patients with tuberculous pleural effusion and 102 patients without tuberculous pleural effusion. Number of spot forming cells (SFCs) as well as the specificity and sensitivity of the tests were compared between these two methods (ELISPOT using leural effusion or peripheral blood). Results The area under the ROC curve was 0.947 in pleural effusion Elispot test while it was 0.905 in peripheral blood Elispot test. The sensitivity of pleural effusion ELISPOT test in diagnosis of tuberculous pleurisy (95.1%) was significantly higher than that of peripheral blood ELISPOT test (89.0%). What’ s more,the specificity of pleural effusion ELISPOT test in diagnosis of tuberculous pleurisy (90.2%) was higher than that in diagnosis of peripheral blood ELISPOT test (88.2%). Conclusion The pleural effusion ELISPOT test is more valuable than peripheral blood ELISPOT in the diagnosis of tuberculous pleuritis.