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目的评价浆膜腔积液和外周血结核感染T细胞斑点试验(T-SPOT.TB)在结核性浆膜炎诊断中的临床应用价值。方法检测浆膜腔积液T-SPOT.TB、腺苷酸脱氨酶(ADA)和外周血T-SPOT.TB,评价其在结核性浆膜炎诊断中的敏感度、特异度、阴性预测值和阳性预测值。结果浆膜腔积液T-SPOT.TB诊断结核性浆膜炎的敏感度为95.83%,显著高于外周血T-SPOT.TB(75.00%)和浆膜腔积液ADA(70.83%),差异有统计学意义(P<0.01)。浆膜腔积液T-SPOT.TB的阴性预测值为90.48%,显著高于外周血T-SPOT.TB和浆膜腔积液ADA(60%、51.72%),差异有统计学意义(P<0.01)。浆膜腔积液T-SPOT.TB诊断临界值为86 SFCs/106,特异度为83.3%。浆膜腔积液T-SPOT.TB曲线下面积是0.928,显著高于外周血T-SPOT.TB和胸腔积液ADA曲线下面积(0.790、0.804)。结论浆膜腔积液T-SPOT.TB诊断效能明显高于外周血T-SPOT.TB和浆膜腔积液ADA,可作为诊断结核性浆膜炎有效的辅助手段。
Objective To evaluate the clinical value of T-SPOT.TB in the diagnosis of tuberculous serositis by serosal effusion and peripheral blood mononuclear infection. Methods T-SPOT.TB, adenosine deaminase (ADA) and T-SPOT.TB were detected in serous effusions to evaluate their sensitivity, specificity and negative predictive value in the diagnosis of tuberculous serositis Value and positive predictive value. Results The sensitivity of serosal effusion T-SPOT.TB for diagnosing tuberculous serositis was 95.83%, which was significantly higher than that of peripheral blood T-SPOT.TB (75.00%) and serosal effusion ADA (70.83%), The difference was statistically significant (P <0.01). The negative predictive value of T-SPOT.TB in serous effusions was 90.48%, which was significantly higher than that of peripheral blood T-SPOT.TB and serous effusion ADA (60%, 51.72%) (P <0.01). Serum effusion T-SPOT.TB diagnostic threshold of 86 SFCs / 106, a specificity of 83.3%. The area under the curve of serosal effusion T-SPOT.TB was 0.928, which was significantly higher than the area under the curve of T-SPOT.TB and pleural effusion ADA (0.790, 0.804). Conclusions The diagnosis of serosal effusion T-SPOT.TB is more effective than T-SPOT.TB and serosal effusion ADA, which can be used as an effective adjunct to diagnose tuberculous serositis.