ADA、IFN-r测定对结核性和癌性胸液鉴别诊断的研究  

The study of detecting adenosine deaminase interferon gamma in differentiating tuberculous pleural effusion and neoplastic pleural effusion

作　　者：朱晓平[1,2] 张锦[1,2] 张建荣[1,2] 潘月英[1,2] 郑西卫[1,2] 吴振裘[1,2] 许德风[1,2] 李秀忠[1,2] 周玮[1,2] 

机构地区：[1]宁夏医学院附属医院呼吸内科 [2]宁夏医学院附属医院中心实验室

出　　处：《宁夏医学杂志》1999年第7期389-391,共3页Ningxia Medical Journal

基　　金：宁夏自治区卫生厅科研基金

摘　　要：目的探讨ＡＤＡ、ＩＦＮ－ｒ测定对诊断结核性、癌性胸液的价值。方法对６７例各种胸液病人同步测定血清、胸水ＡＤＡ（腺苷脱氨酶）ＩＦＮ－ｒ（干扰素－ｒ）水平；ＡＤＡ采用改进的Ｇｉｕｓｔｉ法，ＩＦＮ－ｒ采用双抗体夹心Ｅｌｉｓａ法。结果结核性胸液组ＰＡＤＡ、Ｐ／ＳＡＤＡ、ＰＩＦＮ－ｒ与癌性胸液组有极显著性差异（Ｐ＜０．００１）；三项指标对诊断结核性胸膜炎的敏感度分别是８８％、９２％、９６％，特异度分别是８５．７１％、８８．０９％、９８％；三项指标联合测定对诊断结核性胸液的特异度是９９．６１％。结论ＩＦＮ－ｒ对诊断结核性胸液是一个很有价值的生化指标，若联合ＡＤＡ测定则诊断结核性、癌性胸液意义更大。Objectives To study the roles of adenosine deaminase (ADA) and interferon Gamma (IFN-r) for diagnosis of tuberculous and neoplastic exudates.Methods The activity of ADA and IFN-r in the serum and the pleural fluid of from 67 patients were detected Using the method of Giusti and of a solid-phase enzymeimmunoassay employing the multiple antibody sandwich principle respectively.Results The mean ADA and IFN-r concentration of the tuberculous exudates differed significantly from those of the neoplastic exudates ( P <0.001).The mean pleural serum ADA ratio (P/S ADA) of the tubercuclous exudates differed significantly from those of the neoplastic exudates.ADA (With a diagnostic threshold of 40U/L1)IFN-r (140pg/ml) and P/SADA (1.5) had sensitivities for tuberculousis of 88%、92% and 96% respectively,Specificites of 85.71%、88.09% and 98%.These three paremeters Combined had specificites for tuberculous exudates of 99.61%.Conclusions IFN-r is a useful paremeters for diagnosis of tuberculous exudates.It shows important significance to combine ADA with IFN-r for diagnosis of the tuberculous and neoplastic exudates

关 键 词：结核性 癌性 胸腔积液 鉴别诊断 

分 类 号：R561.3[医药卫生—呼吸系统]