P-选择素等多项指标检测在胸腔积液鉴别中的应用价值  

The clinical diagnostic value of detection of P-selectin, IL-1α, sFas, sFasL, AM in differentiating tuberculous pleural effusions from malignant pleural effusions

作　　者：王英年[1] 刘加洪[1] 孙荣丽[1] 李黎[1] 官明德[1] 于华[1] 马学真[1] 张春玲[1] 赵云峰[2] 王瑞兰[1] 

机构地区：[1]青岛大学医学院二附院青岛市中心医院青岛市结核病防治研究所,青岛266043 [2]南京中大医院,南京210009

出　　处：《中国防痨杂志》2007年第1期8-11,共4页Chinese Journal of Antituberculosis

摘　　要：目的分别检测结核性与恶性胸腔积液(以下简称胸液)中检测P-选择素、IL-1α、sFas、sFasL、AM(肾上腺髓质素)含量并与癌胚抗原(CEA)比较,探讨各检测方法及联合检测在结核性与恶性胸液鉴别诊断中的价值。方法在结核性与恶性胸液中,应用ELISA法检测P-选择素、IL-1α、sFas、sFasL的含量;用放射免疫法(RIA)分别检测AM与CEA含量,对所得数据进行统计学处理。结果(1)结核性胸液中P-选择素、IL-1α含量均明显低于恶性胸液组,分别为(t=8．71,P<0．01),(t= 6．80,P<0．01);(2)结核性胸液中sFas、sFasL含量均明显高于恶性胸液组,分别为(F=4．451,t= 6．422,P<0．001);(F=5．760,t=6．866,P<0．001);(3)结核性胸液中AM、CEA含量均明显低于恶性胸液组,分别为(t=7．49,P<0．05);(t=6．37,P<0．01)。结论P-选择素、IL-1α、sFas、sFasL与AM在对结核性与恶性胸液的鉴别诊断上,敏感性、特异性及临床诊断符合率均高于CEA,有较高的临床实用价值。ELISA法中以P-选择素为优,放免法以AM为优,联合检测可明显提高其临床诊断符合率。Objective To evaluate the diagnostic values and clinical significance of detecting P-selectin, IL-1α, soluble Fas, soluble FasL and adrenomedullin（AM）in pleural effusions in different tuberculous pleural effusions and malignant pleural effusions, and compare with CEA. Methods The level of P-seleetin, IL-1α, soluble Fas, soluble FasL in tuberculous and malignant pleural effusions were determined by Enzyme-linked immunosorbent assay（ELISA）, and that of AM and CEA were determined by radioimmunoassay（RIA）. Results （1）The level of P-seleetin and IL-1α in tuberculous pleural effusions was markedly lower than that in malignant pleural effusions（ t = 8.71, P 〈 0.001 ） . （2） The level of sFasL and sFas in tuberculous pleural effusions was markedly higher than that in malignant pleural effusions（ t = 6.80, P 〈 0.001; F = 4.451, t = 6.422, P 〈 0. 001 ）. （3）The level of AM and CEA in tuberculous pleural effussions was markedly lower than that in malignant pleural effusions（t=7.491,P〈0.05;t=6.37,P〈0.01）. Conclusion The joint deteetion of P-seleetin,IL-1α,sFas ,sFasL, AM and CEA might be helpful to differential diagnosis of tuberculosis pleural effusion and malignant pleural effusion.

关 键 词：P-选择素 IL-1Α SFAS SFASL 肾上腺髓质素(AM) 癌胚抗原(CEA) 胸腔积液 结核 胸腔积液 恶性 诊断 

分 类 号：R561[医药卫生—呼吸系统]