多项指标测定对胸腔积液鉴别诊断价值研究  

Investigation on differential diagnostic value of multi index detection of pleural effusion

作　　者：朱晓萍[1] 张锦[1] 郑西卫[1] 吴振裘[1] 潘月英[2] 

机构地区：[1]宁夏医学院附属医院呼吸内科,银川750004 [2]宁夏医学院附属医院,银川750004

出　　处：《肺癌杂志》1999年第2期77-79,共3页

摘　　要：目的　探讨腺苷脱氨酶(ADA)、γ干扰素(IFNγ)、癌胚抗原(CEA)对诊断结核性、恶性胸腔积液(简称胸液)的价值。方法　对67例胸液患者同步测定血清、胸液ADA、IFNγ、CEA水平。ADA采用改进的Giusti法,IFNγ采用双抗体夹心ELISA法,CEA采用放免法。结果　结核性胸液组胸液ADA、IFNγ水平与恶性胸液组差异有显著性(P<0.001),恶性胸液组血清和胸液CEA水平与结核性胸液组差异有显著性(P<0.05)。ADA(阳性界值≥40U/L)、IFNγ(≥140pg/mL)对诊断结核性胸液的敏感度分别是88%、96%,特异度分别是85.71%、97.62%,诊断指数分别是73.71%、93.62%。胸液中ADA、IFNγ水平无明显升高,而CEA水平明显升高者联合试验对诊断恶性胸液的特异度是90.64%。结论　检测胸液ADA、IFNγ。Objective To study the roles of adenosine deaminase(ADA), interferon gamma(IFN γ) and carcinoembryonic antigen(CEA) for diagnosis of tuberculous and neoplastic pleural effusion. Methods ADA, IFN γ and CEA activity in the serum and pleural fluid were detected in 67 patients with pleural effusion by the method of Guisti, a solid phase enzyme immunoassay employing the multiple antibody sandwich principle, and radioimmunoassay respectively.Results The mean ADA and IFN γ concentration in the tuberculous pleural effusion differed significantly from those in the neoplastic pleural effusion (P<0.001). The mean CEA concentration in the serum and pleural fluid with the neoplastic pleural effusion differed from those with the tuberculous pleural effusion (P<0.05). The sensitivity of ADA (with a diagnostic threshold of 40 U/L) and IFN γ(threshold of 140 pg/mL) for tuberculosis was 88% and 96% respectively, the specificity was 85.71% and 97.62%, and diagnostic index was 73.71% and 93.62% . Using the ADA (with below 40 U/L) and IFN γ (below 140 pg/mL) and CEA (above 15 μg/L), we achieved a specificity of 95.95% for diagnosis of neoplastic pleural effusion. Conclusion ADA, IFN γ and CEA are useful parameters in differential diagnosis of tuberculous and neoplastic pleural effusion.

关 键 词：胸腔积液 结核性 恶性 鉴别 ADA TNFγ CEA 

分 类 号：R561.304[医药卫生—呼吸系统]