趋化因子干扰素诱导蛋白10和sLDH/pADA比值对恶性胸水诊断价值及与疗效的关系  

The diagnostic value of chemokine interferon-inducible protein 10 and sLDH/pADA ratio in malignant pleural effusion and its relationship with efficacy

作　　者：张信鸽 刘新[2] 赵丹晖 ZHANG Xin-ge;LIU Xin;ZHAO Dan-hui(Nanyang Tuberculosis Control Center,Nanyang,Henan 473000;Henan Chest Hospital,Zhengzhou,Henan 450000;Xi'an Xijing Hospital,Xi'an,Shaanxi 710000,China)

机构地区：[1]南阳市结核病防治所结核病区,河南南阳473000 [2]河南省胸科医院,河南郑州450000 [3]西安西京医院,陕西西安710000

出　　处：《热带医学杂志》2020年第9期1168-1172,共5页Journal of Tropical Medicine

基　　金：河南省医学科技攻关计划项目(2018062456)。

摘　　要：目的探究胸水趋化因子干扰素诱导蛋白10(pIP-10)、血清乳酸脱氢酶/胸水腺苷脱氨酶(sLDH/pADA)比值对恶性胸水诊断价值及与疗效的关系。方法选取南阳市结核病防治所2017年3月-2019年5月收治的结核性胸膜炎(TP)患者72例作为TP组,恶性胸水患者58例作为恶性组。检测两组pIP-10、pADA、sLDH水平、sLDH/pADA比值,并分析其诊断价值。对恶性胸水患者给予贝伐珠单抗联合顺铂胸腔内治疗,对比不同疗效患者pIP-10、sLDH/pADA比值及其与疗效的相关性。结果恶性组pIP-10、血清pADA低于TP组,sLDH、sLDH/pADA比值高于TP组(P<0.05)。ROC分析表明,pIP-10、sLDH、pADA、sLDH/pADA比值具有一定的鉴别诊断价值,AUC分别为0.789、0.683、0.641、0.832,其中sLDH/pADA比值的诊断价值较高。4个指标联合应用的鉴别诊断价值更高,AUC为0.903,灵敏度和特异度分别为0.862、0.875。缓解者治疗3个周期后pIP-10高于未缓解者,sLDH/pADA比值低于未缓解者(P<0.05);恶性胸水患者pIP-10与疗效呈正相关(r=0.452,P<0.05),sLDH/pADA比值与疗效呈负相关(r=-0.513,P<0.05)。结论 pIP-10联合sLDH/pADA比值对鉴别诊断TP与恶性胸水具有一定价值,可为临床明确渗出性胸水性质、评估疗效提供数据支持。Objective To explore the relationship between pleural effusion chemokine interferon-inducible protein 10(pIP-10) and serum lactate dehydrogenase/pleural fluid adenosine deaminase(sLDH/pADA) ratio in the diagnosis of malignant pleural effusion and its relationship with therapeutic efficacy.Methods 72 cases of tuberculous pleurisy(TP) patients admitted to our hospital from March 2017 to May 2019 were selected as TP group,and 58 patients with malignant pleural effusion were selected as malignant group.The pIP-10,pADA,sLDH level,sLDH/pADA ratio were detected in the two groups,and their diagnostic value was analyzed.Patients with malignant pleural effusion were treated with bevacizumab combined with cisplatin in the thoracic cavity,and the ratio of pIp-10 and sLDH/pADA of pleural effusion in patients with different therapeutic effects and their correlation with the efficacy were compared.Results The pIP-10 and pADA in the malignant group were lower than those in the TP group,and the sLDH and sLDH/pADA ratios were higher than those in the TP group(P<0.05).ROC analysis showed that the four indicators had certain differential diagnostic value;AUC were0.789,0.683,0.641 and 0.832,respectively,and the diagnostic value of sLDH/pADA ratio was higher.The combined application of all indexes had higher value in differential diagnosis,and the sensitivity and specificity were 0.862(50/58)and 0.875(63/72),respectively.After 3 cycles of treatment,the pleural effusion pIP-10 in the patients with remission was higher than that in the patients without remission,and the sLDH/pADA ratio was lower than that in the patients without remission(P<0.05).In patients with malignant pleural effusion,there was a positive correlation between pIP-10 and efficacy,and a negative correlation between sLDH/pADA ratio and efficacy(P<0.05).Conclusion The pleural effusion pIP-10 combined with serum sLDH/pADA ratio had certain value for the differential diagnosis of TP and malignant pleural effusion,and it could be used for clinical clarification of the natu

关 键 词：趋化因子干扰素诱导蛋白10 乳酸脱氢酶 胸水腺苷脱氨酶 结核性胸膜炎 

分 类 号：R521.7[医药卫生—内科学]