基于胸腔镜病理学的Xper技术联合胸腔积液ADA、LDH诊断结核性胸膜炎的价值  

Value of xperia technique combined with epidural effusion ada and ldh based on thoracos coscopic pathology in diagnosis of tuberculosis pleurisy

作　　者：朱伟 朱艳 ZHU Yan;ZHU Wei(Edong medical group maternal and child health hospital,Huangshi 435000,China)

机构地区：[1]湖北省黄石市鄂东医疗集团市妇幼保健院,435000

出　　处：《中国煤炭工业医学杂志》2023年第4期352-356,共5页Chinese Journal of Coal Industry Medicine

基　　金：湖北省自然科学基金(编号:WJ2019M043)。

摘　　要：目的 探讨结核分枝杆菌/N福平耐药实时荧光定量核酸扩增检测体系(Gene XpertMTB/RIF)联合胸腔积液中腺苷脱氨酶(ADA)、乳酸脱氢酶(LDH)检测对于诊断结核性胸膜炎的价值。方法 选取我院胸外科经胸腔镜取活组织病理学检查证实为结核性胸膜炎的胸腔积液患者87例作为结核组、66例肺部肿瘤导致胸腔积液的患者作为肿瘤组;对比二组胸腔积液中LDH、ADA水平,并对二组胸膜组织进行Gene Xpert MTB/RIF检测,以病理学结果作为诊断金标准,分析三项诊断方法单用或联合应用时诊断结核性胸膜炎的价值。结果 结核组的胸水ADA、Gene XpertMTB/RIF检测CT值高于肿瘤组,差异具有统计学意义(P<0.05);结核组的胸水LDH低于肿瘤组,差异具有统计学意义(P<0.05);ADA单独应用鉴别诊断结核性胸膜炎与癌性胸膜炎的灵敏度为43.68%、特异度为62.12%;LDH单独应用鉴别诊断结核性胸膜炎与癌性胸膜炎的灵敏度为24.14%、特异度为42.42%;Gene XpertMTB/RIF单独应用鉴别诊断结核性胸膜炎与癌性胸膜炎的灵敏度为86.21%、特异度为92.42%;Gene XpertMTB/RIF联合ADA鉴别诊断结核性胸膜炎与癌性胸膜炎的灵敏度为97.70%、特异度为95.45%;Gene XpertMTB/RIF联合LDH鉴别诊断结核性胸膜炎与癌性胸膜炎的灵敏度为83.91%、特异度为92.42%。结论 Gene XpertMTB/RIF单独应用时鉴别诊断结核性胸膜炎与癌性胸膜炎已经具有较高的灵敏度与特异度,再联合胸水ADA检测可进一步提高诊断学价值,联合胸水LDH对于提高诊断能力意义不大。Objective To explore the real-time fluorescent quantitative nucleic acid amplification detection system(GeneXpert MTB/RIF) combined with the detection of adenosine deaminase(ADA) and lactate dehydrogenase(LDH) in pleural effusion for the diagnosis of tuberculosis The value of sexual pleurisy. Methods 87 patients with pleural effusion confirmed by tuberculous pleurisy in the thoracic surgery department of our hospital were selected as the tuberculosis group, and 66 patients with pleural effusion caused by lung tumors were selected as the tumor group;compared the two groups of pleural effusions.The levels of LDH and ADA in the liquid were detected by GeneXpert MTB/RIF on the pleural tissues of the two groups.The pathological results were used as the diagnostic gold standard to analyze the value of the three diagnostic methods in the diagnosis of tuberculous pleurisy when used alone or in combination. Results The CT values of pleural fluid ADA and GeneXpert MTB/RIF in the tuberculosis group were higher than those of the tumor group, the difference was statistically significant(P<0.05);the pleural fluid LDH of the tuberculosis group was lower than the tumor group, and the difference was statistically significant(P<0.05);ADA alone has a sensitivity of 43.68% and a specificity of 62.12% in the differential diagnosis of tuberculous pleurisy and cancerous pleurisy;LDH alone has a sensitivity of 24.14% and a specificity of 42.42% in the differential diagnosis of tuberculous pleurisy and cancerous pleurisy;GeneXpert MTB/RIF alone has a sensitivity of 86.21% and a specificity of 92.42% in the differential diagnosis of tuberculous pleurisy from cancerous pleurisy;GeneXpert MTB/RIF combined with ADA has a sensitivity of 97.70% and a specificity of 95.45 in the differential diagnosis of tuberculous pleurisy from cancerous pleurisy %;GeneXpert MTB/RIF combined with LDH has a sensitivity of 83.91% and a specificity of 92.42% in the differential diagnosis of tuberculous pleurisy and cancerous pleurisy. Conclusion GeneXpert MTB/RI

关 键 词：GeneXpert MTB/RIF 胸腔积液 腺苷脱氨酶 乳酸脱氢酶 结核性胸膜炎 

分 类 号：R54[医药卫生—心血管疾病]