血清及胸腔积液抗PPD-IgG检测对结核性胸腔积液的诊断价值

目的　评价血清、胸腔积液抗PPD-IgG检测对结核性胸腔积液的诊断价值。方法 采用酶联免疫吸附法(ELISA)检测58例结核性胸腔积液的血清、胸腔积液抗PPDIgG,同时与胸膜活检及胸腔积液抗酸杆菌阳性率作比较,并随机选择42例非结核性胸腔积液作为对照组。结果 结核性胸腔积液血清、胸腔积液抗PPD-IgG阳性率(82.8%,96.6%)与胸膜活检阳性率(56.9%),胸腔积液抗酸杆菌阳性率(0%)比较,有显著性差异(P<0.005)。与对照组血清、胸腔积液抗PPDIgG阳性率(11.9%,21.4%)比较,有显著性差异(P<0.005)。本法血清抗PPD-IgG敏感性为82.8%,特异性为88.1%,准确性为85.0%。胸腔积液抗PPD-IgG敏感性为96.6%,特异性为78.6%,准确性为89.0%。结论 同时检测血清、胸腔积液抗PPDIgG可作为诊断结核性胸腔积液的一种可行的辅助方法。

The diagnostic value of Anti-PPD-IgG in serum and pleural effusion for tuberculous pleural effusion

Objective To ascertain the diagnostic of anti PPD IgG in serum and pleural effusion for the tuberculous pleural effusion.Methods Anti PPD IgG in serum and pleural effusion were obtained from 58 tuberculous pleural effusion cases detected by using enzyme linked immunosor bent assay (ELISA) while comparing with the positive rate of pleural biopsy and Mycobacterium tuberculosis in pleural effusion of these cases.42 cases of non tuberculous pleural effusion wewre randomly selected as control.Results The positive rate of Anti PPD IgG in serum (82.8%) and pleural effusion (96.6%) in tuberculous pleural effusion group were higher than that of pleural biopsy (56.9%, P<0.005 ) and Mycobacterium tuberculosis in pleural effusion (0%, P<0.005 ) and also higher than those of Anti PPD IgG in serum (11.9%, P<0.005 ) and pleural effusion (21.4%, P<0.005 ) of the control group,which with statistical significance.The sensitivity,specificity and accuracy of Anti PPD IgG in serum and pleural effusion to diagnose the tuberculous pleural effusion were 82.8%,88.1%,85.0% and 96.6%,78.6%,89.0% respectively.Conclusion The results suggested that detection of Anti PPD IgG in serum and pleural effusion by ELISA method was useful for diagnosis of tuberculous pleural effusion.