【摘要】 目的探讨联合测定胸腔积液中Toll样受体2(Toll-like receptor 2,TIR2)和TOLL样受体4(Toll-liker receptor 4,TLR4)的水平对结核性胸腔积液的鉴别诊断价值。方法结核性胸腔积液组31例,恶性胸腔积液组22例。应用酶联免疫吸附测定法测定胸腔积液上清液和血清TLR2、TLR4的浓度,并对结果进行分析。结果 2组胸腔积液TLR2和TLR4均比其在相应血清中的水平高。结核组胸腔积液TLR2水平高于恶性组。受试者工作特征曲线结果显示,TLR2的曲线下面积为0.696(95%可区信区间为0.501～0.849),TLR2浓度截断值取20.9μg/L,灵敏度为66.67%,特异度为80.00%。TLR4的曲线下面积为0.529(95%可区信区间为0.339～0.713),TLR4浓度截断值取37.9μg/L,灵敏度为33.33%,特异度为93.33%。结论联合测定TLR2和TLR4有助于诊断结核性胸腔积液。更多还原

【Abstract】 Objective The study was to compare the diagnostic accuracy of Toll-like receptor 2 (TLR2) and Toll-like receptor 4(TLR4) in tuberculous pleural effusion.Methods The concentrations of soluble TLR2(sTLR2) and soluble TLR4(sTLR4) in pleural effusion and serum samples were determined by enzyme linked immunosorbent assay in 31 patients with tuberculous,22 patients with malignant pleural effusion.Results The concentrations of sTLR2 and sTLR4 in pleural effusions of both groups were significantly higher than those of their respective peripheral blood.The level of sTLR2 in tuberculous pleural effusion was significantly higher than that in malignant pleural effusion.The receiver operating characteristic(ROC) curve analysis was performed for TLR2 and TLR4.The levels of TLR2 generated an area under the ROC curve 0.696(95%confidence interval 0.501 -0.849),at the cut-off value 20.9μg/L,the sensitivity 66.67%,the specificity 80.00%.And TLR4 generated an area under the ROC curve 0.529(95%confidence interval 0.339 - 0.713 ),at the cut-off value 37.9μg/L,the sensitivity of 33.33%,the specificity 93.33%.Conclusion The combination of determining TLR2 and TLR4 in pleural effusion may be helpful for the differential diagnosis of tuberculous pleural effusion and the other pleural effusions.更多还原