摘要
目的 探讨结核感染T淋巴细胞斑点试验(T-SPOT.TB)联合T淋巴细胞亚群分布在结核性胸腔积液和腹水中的诊断价值。方法 回顾性分析2024-01-01-2024-05-30新疆维吾尔自治区阿克苏地区第二人民医院收治的胸腔积液和腹水形成患者的临床资料,根据分泌物病理组织检查,明确找到结核杆菌者40例,未找到结核杆菌的恶性肿瘤细胞者40例。采用t检验或χ^(2)检验比较2组CD3^(+)、CD4^(+)、CD8^(+)等T淋巴细胞亚群分布和T-SPOT.TB检测情况,并分析其诊断价值。结果 结核组CD3^(+)T淋巴细胞百分比为(86.8±6.2)%,高于非结核组的(62.3±3.5)%,t=12.881,P<0.001;CD8^(+)T淋巴细胞百分比为(43.6±2.8)%,高于非结核组的(20.8±1.7)%,t=24.714,P<0.001;CD4^(+)T淋巴细胞百分比为(36.3±5.1)%,低于非结核组的(62.5±7.0)%,t=19.132,P<0.001;CD4^(+)/CD8^(+)为0.8±0.1,低于非结核组的3.1±0.2,t=56.569,P<0.001。非结核组T-SPOT.TB阳性率为7.5%(3/40),低于结核组的92.5%(37/40),差异有统计学意义,χ^(2)=54.450,P<0.001。T-SPOT.TB与CD4^(+)T淋巴细胞、CD8^(+)T淋巴细胞联合诊断结核性胸腔积液和腹水的灵敏度、特异度和准确度分别为90.0%(36/40)、82.5%(33/40)和88.8%(71/80),均高于以上指标单独检测。结论 结核性胸腔积液和腹水患者CD4^(+)T淋巴细胞百分比降低,CD8^(+)T淋巴细胞百分比升高,T-SPOT.TB与T淋巴细胞亚群联合检测可提高结核性胸腔积液和腹水的诊断准确性。
Objective To evaluate the diagnostic value of T cell spot of tuberculosis(T-SPOT.TB)combined with T lym-phocyte subset analysis in tuberculous pleural effusion and ascites.Methods A retrospective analysis was conducted on clinical data of patients with pleural effusion and ascites admitted to The Second Peoples Hospital of Aksu Prefecture from January 1,2024,to May 30,2024.Based on pathological examination of secretions,40 cases with confirmed Mycobacterium tuberculosis(TB group)and 4O cases with malignant tumor cells(non-TB group)were included.T lymphocyte subsets(CD3^(+),CD4^(+),CD8^(+))and T-SPOT.TB results were compared between the two groups using t-tests or x tests,and their diagnostic performance was analyzed.Results The TB group showed significantly higher percentages of CD3^(+)T lymphocytes[(86.8±6.2)%us(62.3±3.5)%,t=12.881,P<0.001] and CD8^(+)T lymphocytes[(43.6±2.8)%us(20.8±1.7)%,t=24.714,P<0.001] compared to the non-TB group.The TB group had lower percentages of CD4^(+) T lymphocytes[(36.3±5.1)%us(62.5±7.0)%,t=19.132,P<0.001]and a lower CD4^(+)/CD8^(+)ratio(0.8±0.1 us 3.1±0.2,t=56.569,P<0.001).The positive rate of T-SPOT.TB was significantly higher in the TB group[92.5%(37/40)] than in the non-TB group[7.5%(3/40)],χ^(2)=54.450,P<0.001.The combined detection of T-SPOT.TB,CD4^(+),and CD8^(+)T lymphocytes achieved a sensitivity of 90.0%(36/40),specificity of 82.5%(33/40),and accuracy of 88.8%(71/80),outperforming individual tests.Conclusions Patients with tuberculous pleural effusion and ascites ex-hibit decreased CD4^(+)T lymphocytes,increased CD8^(+)T lymphocytes,and elevated T-SPOT.TB positivity.The com-bined use of T-SPOT.TB and T lymphocyte subset analysis improves diagnostic accuracy for tuberculous effusions.
作者
李佳音
肖梦玲
胡敬函
LI Jiayin;XIAO Mengling;HU Jinghan(Department of Pathology,The Second People's Hospital of Aksu Prefecture,Xinjiang Uygur Autonomous Region Aksu,Xiniiang 843000,China)
出处
《社区医学杂志》
2025年第9期315-318,共4页
Journal Of Community Medicine
