γ-干扰素释放试验联合腹水ADA、CA125对结核性腹膜炎的诊断价值  

Diagnostic value of interferon gamma release assays combined with ascites ADA and CA125 detection in tuberculous peritonitis

作　　者：蒋冬梅 王振华 李贵珍 JIANG Dong-mei;WANG Zhen-hua;LI Gui-zhen(Department of Gastroenterology,Shangqiu Municipal Hospital Affiliated to Henan University,Shangqiu,Henan 476000,China)

机构地区：[1]商丘市立医院消化内科,河南商丘476000

出　　处：《医药论坛杂志》2023年第1期38-42,共5页Journal of Medical Forum

摘　　要：目的 探讨γ-干扰素释放试验(IGRA)联合腹水腺苷脱氨酶(ADA)、糖类抗原125(CA125)对结核性腹膜炎的诊断价值。方法 选择2016年1月至2022年3月河南大学附属商丘市立医院收治的103例腹水患者为研究对象,经病原学检查诊断确诊为结核性腹膜炎患者58例,诊断确诊为非结核性腹膜炎患者45例;结核分枝杆菌(MTB)特异性细胞免疫反应检测试剂盒进行全血IGRA试验;全自动生化分析仪检测腹水中ADA水平,全自动快速发光免疫分析仪检测腹水中CA125水平;ROC曲线分析腹水ADA、CA125对结核性腹膜炎的诊断价值。结果 与非结核性腹膜炎组比较,结核性腹膜炎组患者腹水ADA、CA125水平、IGRA阳性率显著升高(P<0.05);腹水ADA、CA125水平诊断结核性腹膜炎的曲线下面积(AUC)分别为0.722、0.743,敏感度分别为69.00%、62.1%,特异性分别为77.8%、84.4%;IGRA诊断结核性腹膜炎的敏感度为81.03%,特异性为88.88%;腹水ADA、CA125及IGRA并联对结核性腹膜炎进行诊断,敏感度为93.10%,特异性为57.78%;串联对结核性腹膜炎诊断的敏感度为62.07%,特异性为95.56%。结论 IGRA联合腹水ADA、CA125检测能够提高结核性腹膜炎的诊断准确性。Objective To investigate the diagnostic value of interferon gamma release assays(IGRA) combined with adenosine deaminase(ADA) and carbohydrate antigen 125(CA125) in tuberculous peritonitis.Methods A total of 103 ascites patients admitted to our hospital from January 2018 to May 2022 were selected as the study subjects, including 58 patients diagnosed with tuberculous peritonitis and 45 patients diagnosed with non-tuberculous peritonitis by etiological examination;the whole blood IGRA test was carried out with Mycobacterium tuberculosis(MTB) specific cellular immune response detection kit;the ADA level in ascites was detected by automatic biochemical analyzer and CA125 level was detected by automatic rapid luminescence immunoanalyzer;the diagnostic value of ADA and CA125 of ascites in tuberculous peritonitis was analyzed by ROC curve. Results Compared with non-tuberculous peritonitis group, the levels of ADA and CA125 in ascites and IGRA positive rate in tuberculous peritonitis group were significantly increased(P<0.05). The area under curve(AUC) of ascites ADA and CA125 levels in the diagnosis of tuberculous peritonitis were 0.722 and 0.743, respectively. The sensitivity was 69.00% and 62.1% respectively, and the specificity was 77.8% and 84.4% respectively;The sensitivity and specificity of IGRA in the diagnosis of tuberculous peritonitis were 81.03% and 88.88%, respectively;the sensitivity and specificity of ADA, CA125 and IGRA in parallel were 93.10% and 57.78% respectively in the diagnosis of tuberculous peritonitis;the sensitivity and specificity of the three methods in series were 62.07% and 95.56% respectively in the diagnosis of tuberculous peritonitis.Conclusion IGRA combined with ADA and CA125 can improve the accuracy of tuberculous peritonitis diagnosis.

关 键 词：Γ-干扰素释放试验 腺苷脱氨酶 糖类抗原125 结核性腹膜炎 诊断 

分 类 号：R572.2[医药卫生—消化系统]