白介素-27联合腺苷脱氢酶在结核性胸膜炎中的诊断价值  

Diagnostic value of IL-27 combined with adenosine deaminase on tuberculous pleurisy

作　　者：席素雅[1] 乔庆哲 刘薇[1] 商焕霞 张玲[1] 贺向红[2] Xi Suya;Qiao Qingzhe;Liu Wei;Shang Huanxia;Zhang Ling;He Xianghong(Department of Respiratory and Critical Care Medicine,Hebei Chest Hospital,Hebei Shijiazhuang 050041,China;Fifth Department of Tuberculosis,Hebei Chest Hospital,Hebei Shijiazhuang 050041,China)

机构地区：[1]河北省胸科医院呼吸与危重症医学科,河北石家庄050041 [2]河北省胸科医院结核五科,河北石家庄050041

出　　处：《中国医刊》2022年第4期382-385,共4页Chinese Journal of Medicine

基　　金：河北省卫生健康委2020年度医学科研课题(20200826)。

摘　　要：目的探究白介素-27(interleukin-27,IL-27)联合腺苷脱氢酶(adenosine deaminase,ADA)在结核性胸膜炎中的诊断价值。方法选择2019年4月至2021年4月河北省胸科医院收治的50例结核性胸膜炎患者作为结核性胸膜炎组,50例恶性胸腔积液患者作为恶性胸腔积液组,两组患者基础临床资料经倾向性匹配评分,差异无显著性。比较两组患者胸腔积液中IL-27及ADA的水平,使用受试者工作特征(receiver operating characteristic,ROC)曲线分析胸腔积液中单独采用IL-27、ADA及二者联合诊断结核性胸膜炎的效能,采用Spearman检验对结核菌培养阳性率与IL-27、ADA水平的相关性进行分析。结果结核性胸膜炎组胸腔积液IL-27、ADA水平均高于恶性胸腔积液组(P均<0.05)。ROC曲线显示,IL-27、ADA单独及联合诊断结核性胸膜炎的效能均较高(曲线下面积分别为0.862、0.890、0.951,P均<0.05)。Spearman相关分析显示,结核性胸膜炎患者结核菌培养阳性率与IL-27、ADA水平呈正相关(r=0.551、0.660,P<0.05)。结论胸腔积液IL-27、ADA单独及联合诊断结核性胸膜炎均具有重要临床价值,结核菌培养阳性率与IL-27、ADA水平相关。Objective To explore the diagnostic value of interleukin-27(IL-27)combined with adenosine dehydrogenase(ADA)on tuberculous pleurisy.Method 50 patients with tuberculous pleurisy treated in Hebei Chest Hospital between April 2019 and April 2021 were set as tuberculous pleurisy group,and another 50 patients with malignant pleural effusion were selected as malignant pleural effusion group.After propensity matching of basic clinical data of patients in the two groups,there were no significant differences.The levels of IL-27 and ADA were compared between the two groups of patients.Receiver operating characteristic(ROC)curve was used to analyze the diagnostic efficiency of pleural effusion IL-27,ADA and combined detection on tuberculosis pleurisy.Spearman test was used to perform the correlation analysis between positive rate of mycobacterium culture and levels of IL-27 and ADA.Result The levels of IL-27 and ADA in pleural effusion in tuberculous pleurisy group were higher than those in malignant pleural effusion group(all P<0.05).ROC curve results showed IL-27,ADA and combined detection had high diagnostic efficiency in the diagnosis of tuberculosis pleurisy(AUC=0.862,0.890,0.951,all P<0.05).Spearman correlation analysis showed that the positive rate of mycobacterium culture in patients with tuberculous pleurisy was positively correlated with IL-27 and ADA(r=0.551,0.660,P<0.05).Conclusion Pleural effusion IL-27,ADA and combined detection have important clinical value on tuberculous pleurisy,and the positive rate of mycobacterium culture is related to IL-27 and ADA.

关 键 词：白介素-27 腺苷脱氢酶 结核菌 结核性胸膜炎 恶性胸腔积液 

分 类 号：R52[医药卫生—内科学]