白细胞介素-27对结核性胸腔积液的诊断价值  

Diagnostic value of interleukin-27 in tuberculous pleural effusion

作　　者：孙美玲[1] 闫迪[1] 姜淑娟[1] 顾宪民 马卫霞[1] 

机构地区：[1]山东大学附属省立医院呼吸科,济南250021

出　　处：《中华医学杂志》2014年第34期2641-2644,共4页National Medical Journal of China

基　　金：山东省科技发展计划项目（2010G0020227）

摘　　要：目的 探讨白细胞介素（IL）-27对结核性胸腔积液的诊断价值.方法 对2013年3月至2014年2月山东省立医院呼吸科收治的76例胸腔积液患者按照胸腔积液性质分为：（1）结核组：结核性胸腔积液患者40例,其中男22例,女18例;年龄19～73岁;（2）恶性组：恶性胸腔积液患者36例,其中男20例,女16例;年龄33 ～78岁;包括肺癌28例,淋巴瘤3例,食管癌1例,原发部位不确定的肿瘤4例.采用酶联免疫吸附法检测两组患者胸腔积液和血清中的IL-27浓度并进行统计学分析,应用受试者工作特征（ROC）曲线判断其对结核性胸腔积液的诊断价值.结果 结核组胸腔积液中IL-27的浓度为（1 402±321） ng/L,显著高于恶性组的（556±133） ng/L,且显著高于本组血清中的（499±88） ng/L（均P＜0.05）.应用ROC曲线确定IL-27诊断结核性胸腔积液的最佳临界值为838 ng/L,敏感度为95.0％,特异度为97.2％,准确度为96.1％.结论 IL-27对结核性胸腔积液的诊断有重要参考价值,值得临床推广和应用.Objective To explore the diagnostic value of interleukin-27 （IL-27） in tuberculous pleural effusion.Methods A total of 76 patients of pleural effusion treated at Shandong Provincial Hospital from March 2013 to February 2014 in accordance with the natures of effusion fluid were divided into：（1） Tuberculosis group of tuberculous pleural effusion （n =40）,including 22 males and 18 females; aged 19 to 73 years; （2） Malignant group of malignant pleural effusion （n =36）,including 20 males and 16 females; aged 33 to 78 years old; including lung cancer （n =28）,lymphoma （n =3）,esophageal （n =1） and uncertain primary tumor site （n =4）.The effusion and serum levels of IL-27 were detected by enzymelinked immunosorbent assay （ELISA） and the results analyzed.And the curve of receiver operating characteristic （ROC） was employed to determine the diagnostic value of IL-27 in tuberculous pleural effusion.Results The level of IL-27 was （1 402 ± 321） ng/L in tuberculous pleural effusion and it was significantly higher than those in malignant pleural effusion （556 ± 133） ng/L and sera （499 ± 88） ng/L （both P ＜ 0.05）.According to the ROC curve,the cut-off value of IL-27 was 838 ng/L in diagnosing tuberculous pleural effusion.And the rates of diagnostic sensitivity,specificity and accuracy of IL-27 were 95.0％,97.2％ and 96.1％ respectively.Conclusions Detection of pleural effusion IL-27 concentration is of great importance in the diagnosis of tuberculous pleural effusion.And it is worthy of wider clinical promotion.

关 键 词：白细胞介素-27 胸腔积液 结核 胸膜 腺苷脱氨酶 Γ干扰素 

分 类 号：R561.3[医药卫生—呼吸系统]