用积分模型诊断结核性胸膜炎的价值研究  

Value of integral model in diagnosis of tuberculous pleurisy

作　　者：张义宏[1] 张红梅[1] 沈景昊 顾明芳[1] 朱广宇[1] 穆传勇[2] 朱晔涵[2] 

机构地区：[1]苏州市相城人民医院呼吸科,江苏苏州215131 [2]苏州大学附属第一医院呼吸内科,江苏苏州215006

出　　处：《中华医院感染学杂志》2014年第18期4512-4514,共3页Chinese Journal of Nosocomiology

基　　金：江苏省科技厅生命健康科技专项基金资助项目(BL2012023)

摘　　要：目的探讨应用积分模型诊断结核性胸膜炎的价值,以提高胸腔积液的诊断率。方法分析65例结核性胸腔积液和87例恶性胸腔积液患者的临床资料,选取年龄、体温、胸腔积液中的腺苷脱氨酶(ADA)、血清C-反应蛋白(CRP)4个指标建立积分模型,以年龄<37岁、体温>37.8℃、ADA>45U/L或>30U/L、CRP>26mg/L为截点,根据logistic回归方程相关性设置每个指标合适的分值,根据每例患者的指标分值,建立积分模型,利用积分模型作为判断结核性胸腔积液的依据。结果以积分模型分值≥7分作为预测结核性胸腔积液的截点,其敏感性为95.4%、特异性为96.6%、准确性为96.0%。结论积分模型可以简单方便的进行结核性胸腔积液的诊断。OBJECTIVE To explore the value of integral model in diagnosis of tuberculous pleurisy so as to raise the rate of diagnosis of pleural effusions .METHODS The clinical data of 65 patients with tuberculous pleural effusions and 87 patients with malignant pleural effusions were analyzed ,then the four indicators including the age ,body temperature ,adenosine deaminase （ADA） in pleural effusions ,and serum C-reactive protein （CRP） were chosen to establish the integral model ;the more than 37 years of age ,body temperature more than 37 .8 ℃ ,ADA more than 45U/L or 30 U/L ,and CRP more than 26 mg/L were set as the cutoff points ,the appropriate score of each indicator was set according to the logistic regression equation ,and the integral model was established for each pa-tient according to the score of indicator ;the tuberculous pleural effusions were tested on the basis of the integral model .RESULTS By setting the integral model value no less than 7 points as the cutoff point to predict the tuber-culous pleural effusions ,the sensitivity was 95 .4% ,the specificity 96 .6% ,the accuracy 96 .0% .CONCLUSION The integral model is a simple and convenient method for the diagnosis of tuberculous pleural effusions .

关 键 词：积分模型 结核性胸腔积液 鉴别诊断 

分 类 号：R561.1[医药卫生—呼吸系统]