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结核感染T细胞斑点试验诊断结核性胸膜炎研究进展
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- Author:
- No author available
- Journal Title:
- China Medicine
- Issue:
- 2
- DOI:
- 10.3760/cma.j.issn.1673-4777.2013.02.064
- Key Word:
- 结核性胸膜炎;结核感染T细胞斑点试验;诊断
Abstract： 结核性胸膜炎是最常见的胸膜疾病之一,在各种不同病因的胸腔积液中占30％～ 60％,与淋巴结结核并列为最常见的2种肺外结核病[1].我国是结核病高疫情国家,随着HIV/AIDS的流行及肺外结核的增多,结核性胸膜炎也随之增多.一般认为,结核性胸膜炎多发于儿童、青少年.该疾病常见,但是确诊较难,其诊断需依据临床、影像学表现、胸液的各项指标等全方位检查,必要时行胸膜活检及胸腔镜等有创性检查.传统检查手段敏感性和特异性均较差,胸液抗酸杆菌检出率仅5％,培养阳性率也仅25％～37％,且需等待2～6周,被认为是诊断金标准的胸膜活检及组织病理学检查也还有20％左右的阴性结果[2],并且有创性检查不可能被常规采用.近年来,结核感染T细胞斑点试验(T-SPOT.TB)作为一种新的诊断结核感染的免疫学方法已经被越来越广泛的认可并应用于临床.它是应用酶联免疫斑点技术(enzymelinked immunospot assay,ELISPOT)检测机体内经结核分枝杆菌特异性抗原刺激后释放γ干扰素的特异性T淋巴细胞数量,协助诊断结核感染的存在.
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