6项指标联合检测在结核性与肺癌胸腔积液鉴别诊断中的价值  

Differential diagnosis value of 6 indexes in tuberculous and malignant pleural effusion

作　　者：王瑛[1] 徐唯傑 乐军[1] 陈晋[1] 江建蘋[1] 

机构地区：[1]同济大学附属上海市肺科医院结核病临床研究中心,上海市结核病(肺)重点实验室,上海200433

出　　处：《临床肺科杂志》2015年第3期389-391,共3页Journal of Clinical Pulmonary Medicine

基　　金：国家自然科学基金(No 81371775)

摘　　要：目的探讨联合检测ADA(腺苷脱氨酶)、CRP(C反应蛋白)、AMY(淀粉酶)、TNF-α(肿瘤坏死因子-α)、CEA(癌胚抗原)和糖类抗原211(CA211)在鉴别结核性与恶性胸腔积液中的临床意义。方法选取160例胸腔积液患者,其中结核性胸腔积液80例,肺癌恶性胸腔积液80例,运用速率法测定ADA(腺苷脱氨酶),化学发光法测定TNF-α与CEA(癌胚抗原),酶连续监测法测定AMY(淀粉酶),免疫比浊法测定CRP(C反应蛋白)及免疫放射法测定糖类抗原CA211。结果 ADA、TNF-α和AMY在结核性胸腔积液中的含量高于恶性胸腔积液,差异有统计学差异(P<0.05)。CEA和CA211在恶性胸腔积液中的含量高于结核性胸腔积液中的含量,差异有统计学差异(P<0.05)。CRP在结核性胸腔积液中的含量与恶性胸腔积液中的含量无明显差异。结论联合检测ADA、AMY、TNF-α、CEA及糖类抗原CA211有助于结核性与恶性胸水的鉴别诊断,具有一定的临床意义。Objective To investigate the differential diagnostic value of adenosine deaminase （ADA）, C-reactive protein （CRP）, amylase （AMY）, tumor necrosis factor alpha （TNF-ct）, carcino-embryonic antigen （CEA） and carbohydrate antigen 211 （ CA211 ） in malignant and tuberculous pleural effusion. Methods The study selected 160 cases of pleural effusion, including 80 cases of tuberculous pleural effusion and 80 cases of malignant pleural effusion. The levels of ADA, CRP, AMY, TNF-α, CEA and CA211 were determined by performance rate method. Results The concentration of ADA, TNF-α and AMY was significantly higher in the tuberculous pleura/ effusion group than in the malignant pleural effusion group （P 〈0. 05）. The concentration of CEA and CA 211 was significantly lower in the tuberculous pleural effusion group than in the malignant pleural effusion group （ P 〈 0. 05 ）. There was no significant difference in CRP between the two groups. Conclusion The determination of ADA, AMY, TNF-α, CEA and CA211 in pleural effusion has important clinical value for identification malignant and tuberculous pleural effusion.

关 键 词：ADA AMY TNF-α CEA CA211 结核 恶性 胸腔积液 

分 类 号：R734.2[医药卫生—肿瘤] R52[医药卫生—临床医学]