t.spot-tb试验和内科胸腔镜对结核性胸膜炎诊断价值的比较.docVIP

精品论文 参考文献 T.SPOT-TB试验和内科胸腔镜对结核性胸膜炎诊断价值的比较 宋彬 肖建宏 郭国华 　　（福建医科大学附属闽东医院 福建 福安 355000） 　　【摘要】 目的：比较T.SPOT-TB试验和内科胸腔镜对结核性胸膜炎的临床诊断价值。方法：2012年01月至2014年01月我科收住的120例疑似结核性胸膜炎患者均行T.SPOT-TB试验和内科胸腔镜查，并对外周血T.SPOT-TB试验或内科胸腔镜检查阳性患者给予抗结核治疗2周，并观察疗效。结果：T.SPOT-TB试验检查阳性率为95%（114/120），内科胸腔镜检查阳性率为85%（102/120），两组患者确诊率相比较差异有统计学意义（P﹤0.05），且102例内科胸腔镜检查阳性患者外周血T.SPOT-TB试验均阳性。对外周血T.SPOT-TB试验阳性而内科胸腔镜检查阴性患者经抗结核治疗2周后，患者低热、盗汗等结核中毒症状明显减轻，胸腔积液均消失，临床上支持结核性胸膜炎诊断。结论：外周血T.SPOT-TB试验比内科胸腔镜对结核性胸膜炎具有更高的临床诊断价值。 　　【关键词】 T.SPOT-TB试验；内科胸腔镜；结核性胸膜炎 　　【中图分类号】R445 【文献标识码】A 【文章编号】2095-1752（2015）06-0034-02 　　Evaluation of diagnostic value of medical thoracoscopy and T.SPOT-TB assay in tuberculous pleurisy 　　Song Bin, Xiao Jianhong, Guo Guohua.The Affiliated Mingdong Hospital of Fujian Medical University, Fuan 355000, China 　　【Abstract】Objective To evaluate the diagnostic value of T.SPOT-TB assay and medical thoracoscopy in tuberculous pleurisy. Methods From January 2012 to January 2014, 120 patients with suspected tuberculous pleurisy were collected and detected by T.SPOT-TB assay and medical thoracoscopy. Then, the positive patients in T.SPOT-TB assay or medical thoracoscopy were treated with anti-tuberculosis treatment for 2 weeks, and the curative effects were observed. Results Positive rates of T.SPOT-TB assay in 120 patients with suspected tuberculous pleurisy patients were 95% (114/120), which were higher than those in medical thoracoscop (85%, 102/120) (P﹤0.05), and 102 positive patients in medical thoracoscop were also positive in T.SPOT-TB assay. After anti-tuberculosis treatment for 2 weeks, tuberculosis symptoms in the positive patients disappeared and supported the clinical diagnosis of tuberculous pleurisy. Conclusion The clinical diagnostic value of T.SPOT-TB assay is better than medical thoracoscop for tuberculous pleurisy. 　　【Key words】T.SPOT-TB; Medical thoracoscopy; Tuberculous pleurisy 　　在我国，结核性胸膜炎是渗出性胸腔积液中最常见的病因[1]，诊断结核性胸膜炎的金标准是在患者胸腔积液标本中检测或培养出结核分枝杆菌或胸膜活检病