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目的研究腺苷脱氨酶(ADA)、T细胞斑点试验(T-spot)联合检测对结核性胸膜炎疾病诊断的临床意义。方法选取80例疑似结核性胸膜炎患者,采用ADA、T-spot联合检测,利用ROC曲线探讨胸腔积液ADA和T-spot联合检测的阳性率和本文确定的ADA临界值与传统的ADA临界值进行比较。结果 ADA检测诊断ROC曲线下胸腔积液的面积为0.959(95%CI:0.916~1.000),ADA检测对结核性胸膜炎胸腔积液有较高的诊断价值,而当约登指数为最高值时,ADA的临界值设定为22.5IU/L。经诊断,确诊的胸膜炎患者有45例,非结核性胸膜炎患者有35例;采用T-spot检测结核性胸膜炎的阳性率为91.11%,ADA检测的阳性率为80.00%,ADA、T-spot联合检测的阳性率为97.78%;T-spot检测的阳性率明显高于ADA检测的阳性率,差异有统计学意义(P<0.05);ADA、T-spot联合检测的阳性率明显高于ADA和T-spot的单独检测,差异有统计学意义(P<0.05)。结论 ADA、T-spot联合检测结核性胸膜炎的诊断具有较为重要的意义,能够快速、准确地检测患者的胸膜炎,且具有较高的灵敏度,诊断效果较好,可以在临床上推广。
Objective To study the clinical significance of adenosine deaminase (ADA) and T-spot test in the diagnosis of tuberculous pleurisy disease. Methods Eighty patients with suspected tuberculous pleurisy were enrolled in this study. The positive rates of ADA and T-spot in pleural effusion were determined by ROC curve analysis using ADA and T-spot. The ADA threshold value determined in this study was compared with the traditional ADA threshold Compare Results The area of pleural effusion under ROC curve of ADA was 0.959 (95% CI: 0.916-1.000). ADA test had a higher diagnostic value for tuberculous pleurisy pleural effusion. When the Youden index was the highest, The critical value of ADA is set at 22.5 IU / L. Among the 45 cases diagnosed and confirmed pleurisy, 35 cases were non-tuberculous pleurisy. The positive rate of T-spot in detecting tuberculous pleurisy was 91.11%, the positive rate of ADA was 80.00%, ADA and T-spot The positive rate of T-spot test was significantly higher than that of ADA test (P <0.05), and the positive rate of ADA and T-spot test was significantly higher than that of ADA and T-spot T-spot alone test, the difference was statistically significant (P <0.05). Conclusion The combined detection of ADA and T-spot in the diagnosis of tuberculous pleurisy is of great significance. It can detect pleuritis in patients rapidly and accurately with high sensitivity and good diagnostic value. It can be widely used clinically.