关键词: 结核性胸膜炎, 胸腔镜, T细胞斑点试验, 结核分枝杆菌, 胸膜活检

Abstract:

Objective To investigate the roles of different methods for the rapid diagnosis of tuberculous pleurisy,and to find a method for rapid diagnosis. Methods A total of 50 patients with undiagnosed exudative pleural effusion were enrolled. Using thoracoscopy,the biopsy specimens of parietal pleura were taken under direct vision. Pleural effusion and biopsy specimens were subjected to bacterial culturing,polymerase chain reaction （PCR）,histopathological microscopic examination （directly and after cytocentrifugation）. Mononuclear cells were isolated from pleural effusion and determined by T cell spot test. Results The biopsy specimens proved to have a higher determination rate of Mycobacterium tuberculosis than pleural effusion. Cytocentrifugation improved the sensitivity of microscopic examination for pleural effusion increasing by 20.0% and biopsy specimens increasing by 37.5%. T cell spot test had higher sensitivity （98.6%） and specificity （95.6%）. Conclusions The combination of microbiological examination and histopathological examination of biopsy specimens is the best method for the diagnosis of tuberculous pleurisy,and microbiological examination using biopsy specimens has a higher determination rate than using pleural effusion. T cell spot test is worth the clinical application for the diagnosis of tuberculous pleurisy.

Key words: Tuberculous pleurisy, Thoracoscopy, T cell spot test, Mycobacterium tuberculosis, Pleural biopsy