EAST—6特异性T淋巴细胞在结核性胸膜炎诊断中的研究

谭俊锋

[摘要] 目的 分析EAST-6特异性T淋巴细胞在结核性胸膜炎诊断中的临床价值。 方法 选取2014年8月～2016年7月我院收治的28例胸腔积液患者为研究对象，按照患者的皮肤结核菌素实验结果，将其分为结核性胸膜炎组（16例）和肿瘤性胸膜炎组（12例），采用酶联免疫斑点测定法（Elispot）对两组患者胸腔积液及外周血中T淋巴细胞内早期分泌抗原靶蛋白6（EAST-6）进行检测，并分析EAST-6对诊断结核性胸膜炎的应用价值。 结果 通过检测发现，结核性胸膜炎组患者的胸腔积液及外周血中T淋巴细胞内EAST-6的阳性检出率分别为87.5%及81.25%，均明显高于肿瘤性胸膜炎组的8.33%及8.33%，差异有统计学意义（P<0.05）；胸腔积液中T淋巴细胞内EAST-6临床诊断的特异度和敏感度分别为84.61%和93.33%，外周血中T淋巴细胞内EAST-6的临床诊断的特异度和敏感度分别为78.57%和92.86%，EAST-6诊断结核性胸膜炎的特异度和敏感度较高。 结论 EAST-6特异性T淋巴细胞在结核性胸膜炎诊断中具有较高的特异性，为临床诊断结核性胸膜炎提供参考依据。

[关键词] EAST-6；结核性胸膜炎；诊断；临床价值

[中图分类号] R521.7 [文献标识码] A [文章编号] 2095-0616（2017）07-207-04

Study on EAST-6 specific T lymphocytes in the diagnosis of tuberculous pleurisy

TAN Junfeng

Department of Respiratory，Foshan Gaoming District People's Hospital， Foshan 528500，China

[Abstract] Objective To analyze the clinical value of EAST-6 specific T lymphocytes in the diagnosis of tuberculous pleurisy. Methods 28 patients with pleural effusion who were admitted to or hospital from August 2014 to July 2016 were selected as the research object.They were allocated to the tuberculous pleurisy group with 16 cases and the cancerous pleurisy group with 12 cases according to results of tuberculin skin tests.Enzyme linked immunospot assay （ELISPOT） were used to detect early secreting antigenic target-6（EAST-6） in T lymphocytes of pleural effusion and peripheral blood and to analyze the applicative value of EAST-6 in the diagnosis of tuberculous pleurisy. Results By testing，it is found that the positive rates of EAST-6 in T lymphocytes of pleural effusion and peripheral blood of patients with tuberculous pleurisy were respectively 87.5% and 81.25%，both significantly higher than those of the cancerous pleurisy group 8.33% and 8.33% （P<0.05）.The specificity and sensitivity of clinical diagnosis of EAST-6 in T lymphocytes of pleural effusion were respectively 84.61% and 93.33% while those of the peripheral blood were respectively 78.57% and 92.86%.In addition，specificity and sensitivity of EAST-6 in diagnosis of tuberculous pleurisy were higher. Conclusion EAST-6 specific T lymphocytes in the diagnosis of tuberculous pleurisy HAS high specificity and it can provide the reference for the clinical diagnosis of tuberculous pleurisy.

[Key words] Early secreting antigenic target-6；Tuberculous pleurisy；Diagnosis；Clinical value

結核性胸膜炎是由结核杆菌引起的胸膜炎症，已成为临床较为常见的结核病[1]，但由于目前缺乏对该病诊断的特异性指标，因此结核性胸膜炎的早期诊断和鉴别仍成为临床研究的重点课题[2]。有研究报道，EAST-6为结核分枝杆菌感染早期分泌的蛋白，具有高度的特异性[3]，本院通过采用酶联免疫斑点测定法对结核性胸膜炎患者胸水及外周血中T淋巴细胞内EAST-6进行检测，取得较好的效果，现将研究结果报道如下。

1 资料与方法

1.1 一般资料

选取我院于2014年8月～2016年7月期间收治的胸腔积液患者28例；对所有患者行超声引导下胸膜活检联合胸水结核分歧杆菌培养[4]，并按照检测结果将患者分为结核性胸膜炎组和肿瘤性胸膜炎组，病例数分别为16例和12例。……