结核分枝杆菌感染T细胞斑点试验对结核性腹膜炎的诊断价值

发布时间：2018-01-17 12:44

本文关键词：结核分枝杆菌感染T细胞斑点试验对结核性腹膜炎的诊断价值　出处：《中华医院感染学杂志》2015年18期 　论文类型：期刊论文

【摘要】：目的探讨结核分枝杆菌感染T细胞斑点试验(T-SPOT.TB)对结核性腹膜炎(TBP)的诊断价值,为临床治疗提供依据。方法选取2013年4月-2014年4月医院确诊的TBP患者30例,在临床未确诊或疑为TBP的25例,非TBP患者30例,通过T-SPOT.TB以及结核菌素试验(PPD)皮试、血清结核抗体(TB-Ab)、腹水腺苷脱氨酶(ADA)等方法检测,评价T-SPOT.TB结核性腹膜炎诊断价值。结果将TBP确诊的和可疑病例作为一组共55例,对照组30例,总共85例患者均经4种方法的检测,T-SPOT.TB检测、PPD皮试、血清TB-Ab、腹水ADA检出阳性率分别为98.18%、49.09%、16.36%、36.36%,T-SPOT.TB检测阳性率与PPD皮试、血清TBAb、腹水ADA检出阳性率差异有统计学意义(P0.05),T-SPOT.TB检测阳性率在TBP与可疑组与对照组之间差异有统计学意义(P0.05);T-SPOT.TB检测的灵敏度为98.18%、假阴性率1.81%、特异度为93.33%、假阳性率为6.67%、正确指数为0.92、符合率为96.47%、阳性预测值为96.43%、阴性预测值为96.55%;PPD皮试灵敏度为49.09%、假阴性率50.90%、特异度为60.00%、假阳性率为40.00%、正确指数为0.09、符合率为52.94%、阳性预测值为69.23%、阴性预测值为39.13%。结论 T-SPOT.TB对诊断结核性腹膜炎具有高的灵敏度和特异度,且快速准确,在筛检和诊断TBP中具有较高的临床应用价值。
[Abstract]:Objective to investigate the diagnostic value of T-SPOT.TB in the diagnosis of tuberculous peritonitis. Methods from April 2013 to April 2014, 30 patients with TBP were selected, including 25 patients with undiagnosed or suspected TBP and 30 patients with non-#en2#. T-SPOT.TB and tuberculin test (PPD) skin test, serum TB antibody TB-Aban, ascites adenosine deaminase (ADAA) and other methods were detected. The diagnostic value of T-SPOT.TB in tuberculous peritonitis was evaluated. Results 55 cases of TBP confirmed and suspected cases and 30 cases of control group were examined by four methods. The positive rates of T-SPOT.TB test, serum TB-Aband ascites ADA were 98.18% and 49.09%, respectively. The positive rate of serum TB-Abb and ascitic fluid ADA was 36.36%. The positive rate of T-SPOT.TB was significantly different from that of PPD skin test, serum TBAband ascites ADA (P 0.05). The positive rate of T-SPOT.TB was significantly different between TBP and suspicious group and control group (P 0.05). The sensitivity of T-SPOT.TB was 98.18, the false negative rate was 1.81, the specificity was 93.33, the false positive rate was 6.67, and the correct index was 0.92. The coincidence rate was 96.47%, the positive predictive value was 96.43 and the negative predictive value was 96.55; The sensitivity of PPD skin test was 49.09, the false negative rate was 50.90, the specificity was 60.000 and the false positive rate was 40.00.The correct index was 0.09. The coincidence rate was 52.94, the positive predictive value was 69.23 and the negative predictive value was 39.13. Conclusion T-SPOT.TB has high sensitivity and specificity in the diagnosis of tuberculous peritonitis. It is rapid and accurate, and has high clinical application value in screening and diagnosing TBP.
【作者单位】：淄博市第一医院结核科;
【基金】：山东省科技攻关基金资助项目(2010GG10002006)
【分类号】：R526
【正文快照】： 结核性腹膜炎(TBP)是由结核分枝杆菌引起的腹膜慢性、弥漫性炎症,感染途径可由腹腔内结核直接蔓延或血行播散而来[1],以中青年多见,女性略多于男性[2]。现在已有很多研究关于结核分枝杆菌感染T细胞斑点(T-SPOT.TB)在结核感染引起的胸腔积液、胸膜炎等疾病中的诊断价值,但是对

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