胸腔积液MNC/LEU比值、ADA与外周血PLR对结核性胸腔积液的诊断价值  

Value of pleural effusion MNC/LEU ratio,ADA and peripheral blood PLR in diagnosing tuberculosis pleural effusion

作　　者：邹泽琛 王勇生 Zou Zechen;Wang Yongsheng(Department of Respiratory and Critical Care,Hefei Hospital Affiliated to Anhui Medical University,Hefei 230011)

机构地区：[1]安徽医科大学附属合肥医院合肥市第二人民医院呼吸与危重症医学科,安徽合肥230011 [2]安徽医科大学第五临床医学院,安徽合肥230032

出　　处：《中国现代医药杂志》2023年第1期28-32,共5页Modern Medicine Journal of China

摘　　要：目的 探讨胸腔积液单个核细胞/白细胞(MNC/LEU)比值、ADA与外周血血小板和淋巴细胞比值(PLR)对结核性胸腔积液的诊断价值。方法 选择我院呼吸介入诊疗中心2019年2月~2022年4月收治的经胸腔镜检查明确胸腔积液类型的80例患者为研究对象,其中结核性胸腔积液(TPE)患者43例(TPE组),恶性胸腔积液患者24例(MPE组),肺炎旁胸腔积液患者13例(PPE组),三组患者均于治疗前抽取胸腔积液进行MNC/LEU、ADA含量测定,并通过血常规数据计算PLR值。比较三组年龄、性别、血常规结果、胸腔积液相关的实验室检测等临床资料,采用受试者工作特征曲线评估其单个和联合检测对TPE的诊断价值。结果 胸腔积液ADA诊断TPE的敏感度、特异性、诊断准确率分别为97.67%、95.59%、96.25%,胸腔积液MNC/LEU比值分别为81.40%、56.76%、70.00%,外周血PLR分别为88.37%、56.76%、73.75%;三者联合诊断则分别为100.00%、97.29%、98.75%。胸腔积液ADA、MNC/LEU比值、外周血PLR单一诊断、三者联合诊断的ROC曲线下面积分别为0.972、0.739、0.710、0.977,联合诊断的诊断效能高于单一诊断。结论 胸腔积液ADA、MNC/LEU比值与外周血PLR联合检测能明显提高TPE诊断的敏感度、特异性及诊断准确率,对TPE具有较高的诊断价值。Objective To investigate the value of pleural effusion mononuclear cell/leukocyte(MNC/LEU) ratio,ADA and peripheral blood platelet to lymphocyte ratio(PLR) in diagnosing the tuberculosis pleural effusion(TPE).Methods From Feb 2019 to Apr 2022, selected 80 cases in respiratory interventional diagnosis center who being all thoracoscopy clear pleural effusion type as the subjects, including 43 patients with tuberculosis pleural effusion(TPE group), 24 patients with malignant pleural effusion(MPE group), 13 patients with parapneumonic effusion(PPE group). Three groups of patients for MNC/LEU, ADA content measurement, and PLR value were intermined before treatment. Clinical data such as age, gender, blood routine results, and pleural effusion-related laboratory tests were compared, and the ROC curve was used to evaluate the diagnostic value of the individual and combined tests for TPE. Results The sensitivity, specificity, and diagnostic accuracy of pleural fluid ADA for the diagnosis of TPE were 97.67%, 95.59%, and 96.25%, respectively. The pleural effusion MNC/LEU ratio were 81.40%, 56.76%, and 70.00%, respectively. The peripheral blood PLR were 88.37%, 56.76%, and 73.75%, respectively. The combined diagnosis were 100.00%, 97.29%, and 98.75%, respectively. The areas under the ROC curves of pleural effusion ADA, pleural effusion MNC/LEU ratio, peripheral blood PLR, and the combined test were 0.972, 0.739, 0.710, and 0.977, respectively, and the diagnostic efficacy of the combined test was higher than that of the individual test.Conclusion The combined test of pleural effusion ADA with peripheral blood PLR and pleural effusion MNC/LEU ratio can significantly improve the sensitivity, specificity and diagnostic accuracy of diagnosing TPE, which has a high diagnostic value for TPE.

关 键 词：胸腔积液 腺苷脱氨酶 单个核细胞/白细胞比值 血小板和淋巴细胞比值 

分 类 号：R561.3[医药卫生—呼吸系统]