血清ADA、LDH及pro-GRP检测在肺结核鉴别诊断中的应用  

Application of serum ADA,LDH and pro ⁃ GRP detection in differential diagnosis ofpulmonary tuberculosis

作　　者：唐文慧[1] 张伟[2] 应会领 TANG Wenhui;ZHANG Wei;YING Huiing(Department of Outpatient,Beijing Daxing District People's Hospital,Beijing,China,102600;Depart-ment of General Surgery,Beijing Daxing District People's Hospital,Beijing,China,102600;Department of Tuberculosis Clinic,Beijing Daxing District People's Hospital,Beijing,China,102600)

机构地区：[1]北京市大兴区人民医院门诊部,北京102600 [2]北京市大兴区人民医院普外科,北京102600 [3]北京市大兴区人民医院结核门诊,北京102600

出　　处：《分子诊断与治疗杂志》2023年第10期1749-1752,1757,共5页Journal of Molecular Diagnostics and Therapy

基　　金：北京市卫生科技发展专项基金(2021-4-3123)。

摘　　要：目的 分析血清腺苷酸脱氨酶(ADA)、乳酸脱氧酶(LDH)及胃泌素释放肽前体(pro-GRP)检测在肺结核鉴别诊断中的应用价值。方法 选择2021年1月至2022年12月北京市大兴区人民医院收治的肺结核患者126例(肺结核组)、肺炎患者108例(肺炎组)、小细胞肺癌患者102例(小细胞肺癌组)。对比三组血清ADA、LDH及pro-GRP水平;采用绘制受试者工作特征(ROC)曲线分析不同检测方法鉴别肺结核、肺炎及小细胞肺癌的诊断价值。采用Kappa一致性检验评估血清ADA、LDH及pro-GRP检测与病理检查诊断肺结核、肺炎及小细胞肺癌的一致性。结果 血清ADA水平比较:肺结核组>小细胞肺癌组>肺炎组,差异具有统计学意义(P<0.05);LDH水平比较:小细胞肺癌组>肺结核组>肺炎组,但小细胞肺癌组与肺结核组比较差异无统计学意义(P>0.05);ADA、LDH、pro-GRP三者联合检测肺结核灵敏度、特异度分别为0.991、0.862,AUC为0.915(P<0.05)。ADA、LDH、pro-GRP三者联合检测肺炎灵敏度、特异度分别为0.951、0.866,AUC为0.955(P<0.05)。ADA、LDH、pro-GRP三者联合检测小细胞肺癌灵敏度、特异度分别为0.959、0.850,AUC为0.962(P<0.05)。血清ADA、LDH及pro-GRP单独及联合检测与病理检查诊断肺结核的一致性Kappa值分别为0.57、0.52、0.43及0.91;血清ADA、LDH及pro-GRP单独及联合检测与病理检查诊断肺炎的一致性Kappa值分别为0.53、0.66、0.57及0.94;血清ADA、LDH及pro-GRP单独及联合检测与病理检查诊断小细胞肺癌的一致性Kappa值分别为0.58、0.51、0.59及0.95。结论 血清ADA、LDH及pro-GRP检测在肺结核鉴别诊断中的具有一定价值,三者联合检测可显著提高肺结核鉴别诊断的灵敏度及特异度。Objective To analyze the application value of the serum adenylate deaminase(ADA),lactate deoxygenase(LDH)and gastrin-releasing peptide precursor(pro-GRP)detection in differential diagnosis of pulmonary tuberculosis.Methods 126 cases of pulmonary tuberculosis patients(pulmonary tuberculosis group),108 cases of pneumonia patients(pneumonia group),and 102 cases of small cell lung cancer patients(small cell lung cancer group)admitted to Daxing District People's Hospital of Beijing from January 2021 to December 2022 were selected.The levels of serum ADA,LDH and pro-GRP were compared among the three groups;the receiver operating characteristic(ROC)curve was drawn to analyze the diagnostic value of different detection methods in differentiating the tuberculosis group,the pneumonia group,and the small cell lung cancer group.The Kappa consistency test was used to evaluate the consistency of serum ADA,LDH and pro-GRP detection and pathological examination in diagnosing pulmonary tuberculosis,pneumonia and small cell lung cancer.Results Comparison of serum ADA level:pulmonary tuberculosis group>small cell lung cancer group>pneumonia group,the difference was statistically significant(P<0.05);comparison of LDH level:small cell lung cancer group>pulmonary tuberculosis group>pneumonia group,but there was no statistically significant difference between small cell lung cancer group and pulmonary tuberculosis group(P>0.05).The sensitivity and specificity of ADA,LDH and pro-GRP combined detection of tuberculosis were 0.991 and 0.862 respectively,AUC was 0.915(P<0.05).The sensitivity and specificity of combined detection of pneumonia by ADA,LDH and pro-GRP were 0.951 and 0.866,AUC was 0.955(P<0.05).The sensitivity and specificity of combined detection of small cell lung cancer by ADA,LDH and pro-GRP were 0.959 and 0.850,AUC was 0.962(P<0.05).The Kappa values of serum ADA,LDH and pro-GRP single and combined detection and pathological examination for the diagnosis of pulmonary tuberculosis were 0.57,0.52,0.43 and 0.91 respectively;the

关 键 词：腺苷酸脱氨酶 乳酸脱氧酶 胃泌素释放肽前体 肺结核 

分 类 号：R521[医药卫生—内科学]