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胸水IFN-γ、ADA在结核性胸膜炎中的诊断价值研究
作者:刘慧梅  张瑞梅  刘加彬  王春颖  席向宇  张礼营 
单位:徐州市传染病医院 结核科, 江苏 徐州 221000
关键词:结核性胸膜炎 γ-干扰素 腺苷脱氨酶 诊断价值 
分类号:R521.7
出版年·卷·期(页码):2016·35·第六期(985-988)
摘要:

目的:评价胸水γ-干扰素(IFN-γ)、腺苷脱氨酶(ADA)在结核性胸膜炎中的诊断价值。方法:选取本院2015年2月至2016年5月收治的胸腔积液患者,其中临床确诊为结核性胸膜炎49例,非结核性胸膜炎43例,分别检测两组胸水IFN-γ、ADA水平,绘制ROC曲线。结果:结核性胸膜炎组胸水IFN-γ、ADA水平明显高于非结核性胸膜炎组(P<0.05);胸水IFN-γ、ADA联合检测ROC曲线面积为0.972(95% CI:0.914~0.995),胸水IFN-γ检测ROC曲线面积为0.889(95% CI:0.807~0.945),胸水ADA检测ROC曲线面积为0.881(95% CI:0.797~0.939),其中联合检测ROC曲线面积大于胸水IFN-γ检测(Z=2.526,P=0.012)和ADA检测(Z=2.864,P=0.004),胸水IFN-γ和ADA检测ROC曲线面积大小差异无统计学意义(Z=0.189,P=0.850)。联合检测试验灵敏度为87.8%,特异度为97.7%;胸水IFN-γ诊断最佳临界值为408 pg·ml-1,灵敏度为81.6%,特异度为88.4%;胸水ADA诊断最佳临界值为25 U·L-1,灵敏度为89.8%,特异度为79.1%。结论:胸水IFN-γ和ADA在结核性胸膜炎中诊断价值较高,联合检测能够提高临床诊断效能。

Objective: To evaluate the diagnostic value of pleural fluid IFN-γ and ADA in patients with tuberculous pleurisy. Methods: From February 2015 to May 2016,patients with suspected tuberculous pleurisy were collected as samples,and they were divided into tuberculous pleurisy group(49 cases) and non-tuberculous pleurisy group(43 cases).Pleural fluid samples in two groups were collected to detect IFN-γ and ADA,and the ROC curve were drawn. Results: According to clinical diagnosis,the mean levels of pleural fluid IFN-γ and ADA in tuberculous pleurisy group were significantly higher than those in non-tuberculous pleurisy group(P<0.05).The area under the ROC curve of pleural fluid combined determination was 0.972(95%CI: 0.914-0.995),the area under the ROC curve of pleural fluid IFN-γ and ADA were 0.889(95%CI: 0.807-0.945) and 0.881(95%CI: 0.797-0.939).The area under the ROC curve of pleural fluid combined determination was bigger than pleural fluid IFN-γ(Z=2.526,P=0.012) and ADA(Z=2.864,P=0.004),and there was no significantly difference between pleural fluid IFN-γ and ADA(Z=0.189,P=0.850).The combined determination of pleural fluid IFN-γ and ADA for the diagnosis of tuberculous pleurisy had a sensitivity of 87.8%,specificity of 97.7%.The best cutoff point,sensitivity,specificity of detecting pleural fluid IFN-γ were 408 pg·ml-1,81.6%,88.4%.The best cutoff point,sensitivity,specificity of detecting pleural fluid ADA were 25 U·L-1,89.8%,79.1%. Conclusion: Pleural fluid IFN-γ and ADA perform well in the diagnosis of tuberculous pleurisy,and combined determination can improve the accuracy of the diagnosis of tuberculous pleurisy.

参考文献:

[1] 许销销.结核性胸腔积液中相关指标与胸膜增厚的关系[D].武汉:华中科技大学,2014.
[2] 李志惠,赵杰,崔丹,等.胸液中IFN-对结核性胸膜炎的诊断价值[J].临床肺科杂志,2014,19(6):1064-1066.
[3] 童朝辉,王臻,徐莉莉,等.可弯曲电子内科胸腔镜在不明原因胸腔积液诊断中的应用[J].中华结核和呼吸杂志,2007,30(5):533-537.
[4] AOE K,HIRAKI A,MURAKAMI T,et al.Diagnostic significance of interferon-tuberculou pleural effusions[J].Chest,2003,123(3):740-744.
[5] 李津,潘燕玉,张宝华,等.IGRA检测在结核性胸膜炎中的诊断价值[J].临床肺科杂志,2014,19(6):1055-1057.
[6] 崔丹,李志惠,赵杰,等.胸水酶联免疫斑点检测在结核性胸膜炎中的诊断价值[J].河北医药,2015,37(8):1191-1193.
[7] 王宏,王永志.ADA、LDH和CEA在胸腔积液鉴别诊断中的应用价值[J].临床肺科杂志,2012,17(3):567-569.
[8] ZOU K H,O MALLEY A J,MAURI L.Receiver-operating characteristic analysis for evaluating diagnostic tests and predictive models[J].Circulation,2007,115(5):654-657.
[9] 刘卫,凌宙贵,汪春梅,等.胸膜活检结合胸水腺苷酸脱氨酶的测定在诊断结核性胸膜炎中的作用[J].实用诊断与治疗杂志,2008,22(2):128-129.
[10] 凌宙贵,刘卫,蒋连强,等.胸膜活检、结核分枝杆菌-PCR及腺苷脱氨酶联合检测诊断结核性胸膜炎[J].中华实用诊断与治疗杂志,2008,22(11):844-845.
[11] 李光明,陆小娜,方育霞.胸腔积液腺苷脱氨酶在诊断结核性胸膜炎中的价值[J].实用医学杂志,2012,28(20):3429-3430.
[12] 彭卫平,王小娟.胸腔积液ADA、IFN-联合检测在结核性胸膜炎诊断中的意义[J].山东医药,2015,55(25):56-57.

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