趋化因子γ-干扰素诱导蛋白-10、巨噬细胞炎性蛋白-1α、单核细胞趋化因子-1对结核性和恶性胸腔积液鉴别诊断的价值分析  

The differential diagnostic value of detecting interferon-γ inducible protein 10, macrophage inflammatory protein-1α and monocyte chemoattractant-1 in tuberculous and malignant pleural effusion

作　　者：任兆强 王相海 林存智[1] 朱新红[3] 刘菲[1] 

机构地区：[1]青岛大学附属医院呼吸科,266003 [2]山东省平邑县人民医院呼吸科 [3]青岛市市立医院内科

出　　处：《中国医师进修杂志》2014年第25期7-9,共3页Chinese Journal of Postgraduates of Medicine

摘　　要：目的探讨趋化因子γ-干扰素诱导蛋白-10（IP-10）、巨噬细胞炎性蛋白-1仅（MIP-1α）、单核细胞趋化因子-1（MCP-1）对结核性和恶性胸腔积液的鉴别诊断价值。方法采用双抗体夹心酶联免疫吸附测定法（EusA）分别检测43例结核性胸腔积液（结核性胸腔积液组）和45例恶性胸腔积液（恶性胸腔积液组）中IP-10、MIP-1α、MCP-1的表达。应用ROC曲线分析两组胸腔积液中IP-10、MIP-1α、MCP-1的表达差异及意义。结果结核性胸腔积液组IP-10、MIP-1α、MCP-1水平显著高于恶性胸腔积液组，差异有统计学意义（t=4．931，3．106，2．385；P=0．000，0．004，0．041）。ROC曲线分析结果显示胸腔积液中IP-10、MIP-1α、MCP-1的诊断临界值为1589．73，213．50，1452．63ng／L；诊断敏感度分别为68．8％，81．3％，87．5％；特异度分别为87．5％，68．8％，56．3％。结论胸腔积液中IP-10、MIP-1α、MCP-1表达对结核性和肿瘤性胸腔积液诊断与鉴别诊断具有重要参考价值。Objective To study the differential diagnostic value of interferon- γ inducible protein 10 （IP-10）, macrophage inflammatory protein-1α （MIP-1α ） and monocyte chemoattractant-1 （MCP-1） level in the tuberculous, malignant pleural effusion. Methods Enzyme-linked immunosorbent assay was used to detect the level of IP-10, MIP-1α and MCP-1 in tuberculous pleural fluid （tuberculous pleural fluid group,43 cases） and malignant pleural fluid （malignant pleural fluid group,45 cases）. The level of IP-10, MIP-1α and MCP-1 and the significance were analyzed by ROC curve. Results The level of IP-10, MIP-1α and MCP-1 were significantly higher in tuberculous pleural fluid group than those in malignant pleural fluid group, and there were significant differences （ t = 4.931,3.106,2.385 ; P = 0.000,0.004,0.041 ）. ROC curve analysis showed that the critical value of IP-10, MIP-1α and MCP-1 in diagnosis of pleural effusion was respectively 1 589.73, 213.50, 1 452.63 ng/L The sensitivity and specificity of IP-10, MIP-1α and MCP-1 in pleural fluid were 68.8%, 81.3%, 87.5% and 87.5%, 68.8%, 56.3%, respectively. Conclusion The level of IP-10, MIP-1α and MCP-1 in tuberculous and malignant pleural fluid are significant for the early diagnosis and differential diagnosis.

关 键 词：胸腔积液 结核 肺 肿瘤 趋化因子 

分 类 号：R561.3[医药卫生—呼吸系统]