【摘要】 【目的】探讨胸腔积液中γ干扰素(IFNγ)和腺苷脱氨酶(ADA)的活性在结核性胸腔积液诊断中的临床价值。【方法】将胸腔积液标本按性质分为三组,即漏出液组、结核组和恶性组。应用酶速率法检测胸腔积液标本中ADA的活性,酶联免疫吸附法(ELISA)检测IFNγ的浓度。比较三组间胸腔积液中ADA活性和IFNγ浓度。【结果】①结核组胸腔积液的ADA活性和IFNγ浓度水平均显著高于恶性组(P<0.01),而恶性组又显著高于漏出液组;②ROC曲线分析结果。IFNγ以107.9ng/L为诊断结核性胸腔积液的临界值;敏感性和特异性分别是92.2%、97.6%;ADA的诊断临界值为43.5U/L,其敏感性和特异性分别为84.3%和90.5%。【结论】胸腔积液中IFNγ、ADA可能是临床鉴别结核性和恶性胸腔积液的有效参考指标,其中以IFNγ诊断价值最大。更多还原

【Abstract】 [Objective]To investigate the diagnostic value of interferon -γ ( IFN-γ) and adenosine deaminase (ADA ) in tuberculous pleural effusions.[Methods]IFN-γ concentrations and ADA activity in all the specimens were determined by ELISA and enzyme kinetic analytical method respectively.[Results]①ADA activity and IFN-γ level in tuberculous effusions were significantly higher than those in malignant effusion respectively ( P <0.01),while those in the latter were significantly higher than those in leakage effusion respectively. ②By analysis of ROC curves,the cut-off values for IFN-γ and ADA were defined. The sensitivity and specificity of IFN-γ for tuberculous effusion were 92.2%and 97.6% respectively. Those of ADA were 84.3% and 90.5%.[Conclusion]IFN-γ and ADA can be used as valuable parameters for the differentiation of tuberculous from malignant effusion,and IFN-γ is more sensitive and specific than ADA.更多还原