[1]郝卉杰,石朝阳,周川,等.结核性腹膜炎诊断方法比较[J].郑州大学学报(医学版),2012,(01):108.
 HAO Huijie,SHI Zhaoyang,ZHOU Chuan,et al.Analysis of diagnosis methods of tuberculous peritonitis[J].JOURNAL OF ZHENGZHOU UNIVERSITY(MEDICAL SCIENCES),2012,(01):108.
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结核性腹膜炎诊断方法比较
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《郑州大学学报(医学版)》[ISSN:1671-6825/CN:41-1340/R]

卷:
期数:
2012年01期
页码:
108
栏目:
应用研究
出版日期:
2012-01-20

文章信息/Info

Title:
Analysis of diagnosis methods of tuberculous peritonitis
作者:
郝卉杰石朝阳周川薛福敏张建立冯百岁#
郑州大学第一附属医院消化内科 郑州450052
Author(s):
HAO HuijieSHI ZhaoyangZHOU ChuanXUE FuminZHANG JianliFENG Baisui
Department of Gastroenterology,the First Affiliated Hospital,Zhengzhou University, Zhengzhou 450052
关键词:
结核性腹膜炎诊断TSPOT.TB腹腔镜
Keywords:
tuberculous peritonitisdiagnosisenzymelinked immunospot assayperitoneoscopy
分类号:
R526
摘要:
目的:分析结核性腹膜炎(TBP)临床诊断方法。方法:搜集确诊的79例TBP患者资料,对其临床特点及血液学指标、腹水生化、影像学、TSPOT.TB及腹腔镜等检查结果进行总结、分析。结果:发病高峰在20~45岁;男女比例为11.55;临床表现以腹胀、腹痛及乏力常见。44.30%(35/79)的患者血常规异常,52.82%(28/53)的患者CT异常,56.25%(36/64)的患者红细胞沉降率(ESR)增快,56.72%(38/67)的患者结明三项阳性,60.00%(39/65)的患者B超异常,73.68%(42/57)的患者腹水CA125升高,80.70%(46/57)的患者腹水ADA活性升高,91.43%(32/35)的患者TSPOT.TB阳性,92.85%(26/28)的患者腹腔镜阳性。腹水ADA、TSPOT.TB、腹腔镜检查诊断率较高。腹水ADA与腹腔镜检查结果有弱一致性(kappa=0.352,P=0.043),TSPOT.TB与腹腔镜结果一致性较好(kappa=0.625,P=0.001)。结论:TSPOT.TB是一种新型的无创的快速诊断TBP的敏感方法;结合患者的临床表现、各项辅助检查结果和试验性抗结核治疗可提高TBP确诊率。
Abstract:
Aim:To analyze clinical diagnosis methods of tuberculous peritonitis(TBP).Methods:The data of 79 TBP patients was collected and analyzed in respects of clinical manifestations,serologic index, biochemistry test of ascites,iconography,TSPOT.TB and peritoneoscope.Results:The peak age of onset was between 20 and 45 years.The male to female ratio was 11.55. Abdominal distention, abdominal pain and malaise were the most common clinical features. Routine blood test was abnormal in 44.30%(35/79), blood sedimentation rate increased in 56.25%(36/64),tuberculosis three items examinations were positive in 56.72%(38/67), ascites carcinoembryonic antigen 125 increased in 73.68%(42/57),positive B ultrasonic of abdomen in 60.00%(39/65),and positive CT of the abdomen in 52.82%(28/53).Activity of ascites adenosine deaminase(ADA) increased in 80.70%(46/57),TSPOT.TB was positive in 91.43%(32/35),and peritoneoscopy was positive in 92.85%(26/28).The result of ascites ADA activity was consistent poorly to peritoneoscopy(kappa=0.352,P=0.043), and TSPOT.TB result was consistent well to peritoneoscopy(kappa=0.625,P=0.001).Conclusion:TSPOT.TB is a new noninvasive and sensitive index for the diagnosis of TBP.Accurate diagnosis rate of TBP should be made on the basis of clinical characteristics,auxiliary examinations and the efficacy of antituberculous therapy.

参考文献/References:

[1]王文虎,龚作炯.结核性腹膜炎的诊断现状和进展[J].长江大学学报:医学卷,2007,4(2):208 [2]李淑德,许国铭.结核性腹膜炎的诊断与治疗[J].胃肠病学,2005,10(3):191 [3]Sanai FM,Bzeizi KI.Systematic review:tuberculous peritonitis:presenting features,diagnostic strategies and treatment[J].Aliment Pharmacol Ther, 2005,22(8):685 [4]周卫敏,王翠肖.结明三项对肺结核诊断的价值探讨[J].当代医学,2010(33):85 [5]Riguelme A,Calvo M,Salech F,et al.Value of adenosine deaminase(ADA) in ascitic fluid for the diagnosis of tuberculous peritonitis:a metaanalysis[J].J Clin Gastroentero,2006,40(8):705 [6]UygurBayramic OL,Dabak C,Dabak R,et al.A clinical dilemma:abdominal tuberculosis [J].World J Gyastroenterol,2003,9(5):1098 [7]Kim SH,Song KH,Choi SJ,et al. Diagnostic usefulness of a Tcellbased assay for extrapulmonary tuberculosis in immunocompromised patients[J].Am J Med,2009,122(2):189 [8]Wu JF,Li HJ,Lee PI, et al.Tuberculous peritonitis mimicking peritonitis carcinomatosis:a case report[J].Eur J Pediatr,2003,162(12):853

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备注/Memo

备注/Memo:
doi:10.3969/j.issn.16716825.2012.01.035 #通讯作者,男,1965年10月生,教授,博士研究生导师,研究方向:炎症性肠病,Email:fengbs@gmail.com
更新日期/Last Update: 1900-01-01