结核分枝杆菌抗原特异反应性白细胞介素-22在结核性胸膜炎鉴别诊断中的应用  

The application of Mtb-antigen-specific Interleukin-22 in the differential diagnosis of Tuberculous Pleurisy

作　　者：原艳明[1,2] 王仲元[3] 王心静[4] 程小星[4] 安慧茹[3] 翟守恒[2] 张玲莉[2] 吕双梅 

机构地区：[1]解放军医学院309临床部结核三科,北京100039 [2]解放军264医院感染科,山西太原030001 [3]解放军309医院结核三科,北京100091 [4]解放军309医院结核病研究室,北京100091

出　　处：《现代仪器与医疗》2014年第3期1-3,共3页Modern Instruments & Medical Treatment

基　　金：国家自然科学基金项目(81071318)

摘　　要：目的 :研究胸液单个核细胞经结核分枝杆菌特异性抗原肽刺激后表达的白细胞介素-22(Interleukin-22,IL-22)浓度测定在结核性与恶性胸腔积液鉴别诊断中的价值。方法 :将确诊的52例结核性胸膜炎和35例恶性胸腔积液患者胸液单个核细胞分离后,使用结核分枝杆菌特异抗原肽(early secreted antigenic target-6,ESAT-6)、(culture filtrate protein-10,CFP-10)刺激培养,测定细胞培养液上清中IL-22和干扰素-γ(Interferon-γ,IFN-γ)浓度,对结果进行统计学分析。结果 :结核性胸膜炎组IL-22浓度明显高于恶性胸液组(P<0.01)。ROC曲线显示IL-22用于结核性胸膜炎的诊断敏感性、特异性和准确性分别为90.38%、80.56%和85.23%,其诊断效能与IFN-γ相当(P>0.05)。结论 :结核分枝杆菌抗原特异反应性IL-22测定可作为对结核性胸膜炎诊断的重要参考指标。Objective：To research the diagnosis value of the measurement of the concentration of Interleukin-22（IL-22）generated by the pleural fluid mononuclear cells（PFMCs）stimulated by specific MTB antigen peptides in tuberculous Pleurisy effusions（TPE）and malignant pleural effusions（MPE）.Methods： The pleural fluid mononuclear cells（PFMCs）of 52 cases of TPE and 35 cases of MPE were separated and cultivated with the stimulation of specific MTB antigen peptides（early secreted antigenic target-6,ESAT-6）、（culture filtrate protein-10,CFP-10）, the concentration of IL-22 and Interferon-γ（IFN-γ）of the PFMCs culture lfuid supernatant were measured and the results were statistically analyzed.Results：The concentration of IL-22 in TPE group was significantly higher than MPE group（P〈0.01）.ROC curve showed the sensibility、speciifcity and the accuracy of IL-22 were 90.38%、80.56% and 85.23% when used in the diagnosis of TPE, the diagnose efifciency was equal to IFN-γ（P〉0.05）.Conclusion： The measurement of the Mtb-antigen-speciifc IL-22 can be regarded as an important reference index in the diagnosis of TPE.

关 键 词：白细胞介素-22 结核性胸膜炎 恶性胸水 鉴别诊断 

分 类 号：R521.7[医药卫生—内科学] R446.62[医药卫生—临床医学]