血浆PCT、血清IL-12检测联合CT诊断肺结核的价值分析  

Value of Plasma PCT and Serum IL-12 Combined with CT in the Diagnosis of Pulmonary Tuberculosis

作　　者：刘占民 杨栋民 陈洪波 LIU Zhan-min;YANG Dong-min;CHEN Hong-bo(Clinical Laboratory,Qinhuangdao Orthopaedic Hospital,Qinhuangdao 066000,Hebei Province,China;Clinical Laboratory,Qinhuangdao Workers'Hospital,Qinhuangdao 066200,Hebei Province,China;Clinical Laboratory,China Railway Shanqiao Group Hospital,Qinhuangdao 066200,Hebei Province,China)

机构地区：[1]秦皇岛市第一医院检验科,河北秦皇岛066000 [2]秦皇岛市工人医院检验科,河北秦皇岛066200 [3]中铁山桥集团医院检验科,河北秦皇岛066200

出　　处：《中国CT和MRI杂志》2022年第7期67-69,共3页Chinese Journal of CT and MRI

摘　　要：目的分析血浆降钙素原(PCT)、血清白介素-12(IL-12)联合CT在诊断肺结核中的价值。方法将77例疑似肺结核的受检者纳为研究对象,采集其空腹静脉血,检测血浆PCT及血清IL-12水平,并进行胸部CT检查,以病理活检为“金标准”,分析血浆PCT、血清IL-12联合CT在诊断肺结核中的应用价值。结果病理检查供确诊45例肺结核患者;CT.检查诊断.肺结核的灵.敏度、特异度及准确度分为8222%、9063%和8571%;45例肺结核患者中,有24例CT检查出现胸膜病变,11例可见支气管播散灶,12例可见肿块状病变,11例可见斑片状阴影,7例可见肺叶或肺段实变;肺结核患者血浆PCT水平显著高于非.肺结核者,血清IL-12水平显著低于非肺结核者(P<005);绘制ROC曲线提示,血浆PCT+血清IL-12.+CT诊断肺.结核的敏感度、特异度较高,分别为8890%和9690%。结论CT是目前诊断肺结核最常用的影像学方式,但其临床漏诊、误诊率高,血浆PCT及血清IL-12均可在一定程度上提示肺结核,CT联合血浆PCT及血清IL-12能有效提高单纯CT诊断的灵敏度及特异度,优化临床诊断效果。Objective To analyze the value of plasma procalcitonin(PCT) and serum interleukin-12(IL-12) combined with CT in the diagnosis of pulmonary tuberculosis. Methods 77 patients with suspected pulmonary tuberculosis were included in the study. Their fasting venous blood was collected, and the levels of plasma PCT and serum IL-12 were measured, and chest CT examination was performed. Pathological biopsy was used as the gold standard to analyze the application value of plasma PCT and serum IL-12 combined with CT in the diagnosis of pulmonary tuberculosis. Results 45 cases of pulmonary tuberculosis were diagnosed by pathological examination. The sensitivity, specificity and accuracy of CT were 82.22%, 90.63% and 85.71% in the diagnosis of pulmonary tuberculosis. Among 45 cases of patients with pulmonary tuberculosis, CT examination showed 24 cases of pleural lesions, 11 cases of bronchial disseminated lesions, 12 cases of mass lesions, 11 cases of patchy shadows and 7 cases of consolidations of lung lobe or lung segments. Plasma PCT level of patients with pulmonary tuberculosis was significantly higher than that of patients with non-pulmonary tuberculosis while the serum IL-12 level was significantly lower than that of patients with non-pulmonary tuberculosis(P<0.05). ROC curve showed that the sensitivity and specificity of plasma PCT+serum IL-12+CT were higher in the diagnosis of pulmonary tuberculosis, with 88.90% and 96.90% respectively. Conclusion CT is the most commonly used imaging method for the diagnosis of pulmonary tuberculosis, but it has high clinical missed diagnosis rate and misdiagnosis rate. Plasma PCT and serum IL-12 can suggest pulmonary tuberculosis to some extent. CT combined with plasma PCT and serum IL-12 can effectively improve the sensitivity and specificity of CT diagnosis alone and optimize the clinical diagnostic effects.

关 键 词：血浆PCT 血清IL-12 CT 联合检查 肺结核 诊断价值 

分 类 号：R521[医药卫生—内科学] R445.3[医药卫生—临床医学]