【摘要】：目的研究酶聯(lián)免疫斑點試驗(ELISPOT)檢測胸水γ干擾素效應(yīng)T細胞對結(jié)核性胸膜炎的診斷價值。方法收集解放軍第三O九醫(yī)院臨床確診的120例結(jié)核性胸膜炎患者和55例其他原因所致胸膜炎患者(如惡性或炎性反應(yīng)等)治療前的胸水單個核細胞(PEMCs)及外周血單個核細胞(PBMCs),用重組CFP10-ESAT6融合蛋白刺激后應(yīng)用ELISPOT法檢測分泌γ干擾素的效應(yīng)T細胞斑點形成細胞數(shù)(SFCs)。結(jié)果結(jié)核性胸膜炎組(結(jié)核組)PBMCs及PEMCs產(chǎn)生的SFCs值均顯著高于非結(jié)核性胸膜炎組(非結(jié)核組)(P0.01),結(jié)核組PBMCs與PEMCs產(chǎn)生的SFCs值差異無統(tǒng)計學(xué)意義(P0.05),但非結(jié)核組PBMCs產(chǎn)生的SFCs值顯著高于PEMCs(P0.05)。結(jié)核組血和胸水性胸膜炎ELISPOT陽性率分別為62.9%和60.8%,與非結(jié)核組36.6%和16.4%比較差異有統(tǒng)計學(xué)意義(P0.05)。結(jié)核組血和胸水ELISPOT陽性率比較差異無統(tǒng)計學(xué)意義(P0.05),但非結(jié)核組血ELISPOT陽性率顯著高于胸水(P0.05)。依據(jù)PEMC ELISPOT結(jié)果診斷結(jié)核的靈敏度為60%(63/105),特異度為82.9%(34/41),優(yōu)于PBMCs和PEMC+PBMCs ELISPOT。結(jié)論胸水ELISPOT檢測是一種較靈敏、特異的結(jié)核性胸膜炎輔助診斷和鑒別診斷方法。
[Abstract]:Objective to study the diagnostic value of interferon gamma effector T cells in pleurisy detected by enzyme linked immunosorbent assay (Elisa). Methods 120 patients with tuberculosis pleurisy and 55 patients with pleurisy caused by other causes (such as malignant or inflammatory reaction) were collected from 120 patients with tuberculosis pleurisy and 55 patients with pleurisy caused by other causes before treatment. (PEMCs) and (PBMCs), of peripheral blood mononuclear cells were detected by ELISPOT after stimulation with recombinant CFP10-ESAT6 fusion protein. ELISPOT assay was used to detect the number of effective T cell dot forming cells secreting interferon gamma. Results the SFS values of PBMCs and PEMCs in tuberculosis pleurisy group (tuberculosis group) were significantly higher than those in non-tuberculosis pleuritis group (P 0.01). There was no significant difference between PBMCs and PEMCs in tuberculosis group (P 0.05), but the SFS produced by PBMCs in non-tuberculosis group was significantly higher than that in non-tuberculosis group (P 0.05). The positive rates of ELISPOT in tuberculosis group were 62.9% and 60.8%, respectively, which were significantly higher than those in non-tuberculosis group (36.6% and 16.4%) (P 0.05). There was no significant difference in the positive rate of ELISPOT between tuberculosis group and pleural effusion (P 0.05), but the positive rate of ELISPOT in non-tuberculosis group was significantly higher than that in pleural effusion (P 0.05). The sensitivity and specificity of PEMC ELISPOT in the diagnosis of tuberculosis were 60% (63 鈮，

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