ADA联合IFN-γ及LAM抗原检测对结核性胸膜炎的诊断价值  

Analysis of diagnostic value of ADA combined with IFN-γ and LAM antigen for tuberculosis pleurisy

作　　者：施健[1] 周丽荣[1] 孙宝华[1] 王晓晟[1] 

机构地区：[1]河北省沧州市中心医院呼吸内一科,061000

出　　处：《疑难病杂志》2014年第1期46-48,共3页Chinese Journal of Difficult and Complicated Cases

摘　　要：目的探讨腺苷脱氨酶（ADA）联合γ-干扰素（IFN-γ）及脂阿拉伯甘露聚糖（LAM）抗原对结核性胸膜炎的诊断价值。方法胸腔积液患者98例按胸腔积液性质是否为结核分为结核组（62例）与非结核组（36例）。对比分析2组患者胸腔积液与血清中ADA、IFN-γ水平及LAM的阳性率,并应用ROC曲线确定ADA联合IFN-γ及LAM抗原对结核性胸膜炎诊断的价值。结果结核组胸腔积液中ADA及IFN-γ水平明显高于非结核组[（53.88±14.39）U/L、（496.82±183.65）pg/ml vs.（15.07±12.36）U/L、（49.74±32.18）pg/ml,P〈0.05];结核组与非结核组血清中ADA及IFN-γ水平的差异比较无统计学意义[（24.31±7.85）U/L、（47.88±8.35）pg/ml vs.（22.94±7.60）U/L、（45.62±7.74）pg/ml,P〉0.05];结核组胸腔积液及血清中LAM抗原的阳性率均明显高于非结核组（64.52%、74.19%vs.2.78%、5.56%,P〈0.05）。胸腔积液中ADA联合IFN-γ及LA M抗原对结核性胸膜炎诊断的准确性较高,其ROC曲线下面积为0.914（95%CI 0.832~1.243）。结论胸腔积液中ADA联合IFN-γ及LAM抗原检测对结核性胸膜炎诊断的准确性较高,值得推广。Objective To explore the adenosine deaminase（ADA）jointγinterferon（IFN-γ）and lipoarabinomannan（LAM）antigen diagnosis of tuberculous pleurisy.Methods Pleural effusion in 98 patients according to whether the nature of tuberculous pleural effusion into tuberculosis group（62 cases）and non-tuberculous group（36 cases）.Comparative analysis of two groups of patients with pleural effusion of serum ADA,IFN-γlevels and LAM positive rate and ROC curve to determine ADA combined IFN-γ and LAM antigen for diagnosis of tuberculous pleurisy value.Results Tuberculous pleural effusion ADA and IFN-y levels were significantly higher than non-tuberculosis group[（53.88±14.39）U/L,（496.82±183.65）pg/ml vs.（15.07±12.36）U/L,（49.74±32.18）pg/ml,P0.05];tuberculous and non-tuberculous group,the serum levels of ADA and.IFN-y no statistically significant difference[（24.31±7.85）U/L,（47.88±8.35）pg/ml vs.（22.94±7.60）U/L,（45.62±7.74）pg/ml,P0.05];tuberculous pleural effusion and serum LAM antigen positive rate was significantly higher than that of non-tuberculous group（64.52%and 74.19%vs.2.78%and 5.56%,P0.05）.Pleural effusion ADA joint IFN-γ and LAM antigen in the diagnosis of tuberculous pleurisy high accuracy,the area under the ROC curve was 0.914（95%Cl 0.832-1.243）.Conclusion Pleural effusion ADA joint IFN-y and LAM antigen detection for the diagnosis of tuberculous pleurisy with high accuracy,is worth promoting.

关 键 词：胸膜炎 结核性 腺苷脱氨酶 Γ-干扰素 脂阿拉伯甘露聚糖抗原 

分 类 号：R521.7[医药卫生—内科学]