胸水IFN-γ释放试验和腺苷脱氨酶活性检测在结核性胸腔积液鉴别诊断中的应用  

Application of interferon-gamma release assay and adenosine deaminase activity test in the diagnosis of tuberculous pleurisy

作　　者：沈荣林[1] 徐金田[2] 陈兆军[3] 毛佳斌[2] 洪理泉[3] 吕群[1] 

机构地区：[1]杭州师范大学附属医院呼吸内科,浙江杭州310015 [2]杭州师范大学附属医院结核科,浙江杭州310015 [3]杭州师范大学附属医院检验科,浙江杭州310015

出　　处：《中国卫生检验杂志》2015年第10期1571-1573,共3页Chinese Journal of Health Laboratory Technology

基　　金：杭州市科技局资助项目(20110833B10)

摘　　要：目的 IFN-γ释放试验(IGRAs)和腺苷脱氨酶(ADA)活性检测被认为是有效的检测胸腔积液的手段。本文主要比较了IGRAs和ADA活性检测的2种方法对结核性胸腔积液的诊断。方法从51例胸腔积液患者中提取胸水样本,分别使用IGRAs、ADA活性检测。IGRAs、ADA活性检测均根据厂家提供的方案进行。诊断时,IFN-γ释放试验的临界值为10 pg/ml,ADA活性检测的临界值为30 U/L。结果胸水IGRAs和ADA检测均可以有效的用于结核病的诊断。在本研究中,IGRAs敏感性为75.0%,特异性为81.8%;ADA的敏感性为77.5%,特异性为100.0%,两者均具有较高的诊断价值。将2种诊断方案结合,可以更加有效的进行诊断。结论胸水IFN-γ释放试验和腺苷脱氨酶活性检测均是有效的检测结核性胸腔积液的诊断方案。Objective Interferon -gamma release assays （IGRAs） and adenosine deaminase activity test（ADA） are considered to be effective for diagnosis of pleural effusion. In this study, we compared the effect of IGRAs and ADA in diagnosis of tubercu- lous pleurisy. Methods Pleural fluids, from 51 patients, were isolated, and respectively tested by IGRAs and ADA according to manufacturer＇ s instructions. The threshold for IGRAs was 10 pg/ml, and for ADA was 30 U/L in the diagnosis. Results Ei- ther of the methods could be used for the diagnosis of tuberculous pleurisy. In this stucty, the sensitivity of IGRAs was 75.0%, and the specificity was 81.8% ; the sensitivity of ADA was 77.5%, and the specificity was 100.0%, both of which showed high value in the diagnosis. Combination of these two methods could improve the diagnosis of tuberculous pleurisy. Conclu- sion Both of IGRAs and ADA could effectively diagnose tuberculous pleurisy.

关 键 词：结核性胸腔积液 胸水IFN-γ释放试验 胸水腺苷脱氨酶活性 

分 类 号：R446.1[医药卫生—诊断学]