【摘要】 目的探讨腺苷脱氨酶(ADA)联合γ-干扰素(IFN-γ)及脂阿拉伯甘露聚糖(LAM)抗原对结核性胸膜炎的诊断价值。方法胸腔积液患者98例按胸腔积液性质是否为结核分为结核组(62例)与非结核组(36例)。对比分析2组患者胸腔积液与血清中ADA、IFN-γ水平及LAM的阳性率,并应用ROC曲线确定ADA联合IFN-γ及LAM抗原对结核性胸膜炎诊断的价值。结果结核组胸腔积液中ADA及IFN-γ水平明显高于非结核组[(53.88±14.39)U/L、(496.82±183.65)pg/ml vs.(15.07±12.36)U/L、(49.74±32.18)pg/ml,P<0.05];结核组与非结核组血清中ADA及IFN-γ水平的差异比较无统计学意义[(24.31±7.85)U/L、(47.88±8.35)pg/ml vs.(22.94±7.60)U/L、(45.62±7.74)pg/ml,P>0.05];结核组胸腔积液及血清中LAM抗原的阳性率均明显高于非结核组(64.52%、74.19%vs.2.78%、5.56%,P<0.05)。胸腔积液中ADA联合IFN-γ及LA M抗原对结核性胸膜炎诊断的准确性较高,其ROC曲线下面积为0.914(95%CI 0.832~1.243)。结论胸腔积液中ADA联合IFN-γ及LAM抗原检测对结核性胸膜炎诊断的准确性较高,值得推广。更多还原

【Abstract】 Objective To explore the adenosine deaminase(ADA)jointγinterferon(IFN-γ)and lipoarabinomannan(LAM)antigen diagnosis of tuberculous pleurisy.Methods Pleural effusion in 98 patients according to whether the nature of tuberculous pleural effusion into tuberculosis group(62 cases)and non-tuberculous group(36 cases).Comparative analysis of two groups of patients with pleural effusion of serum ADA,IFN-γlevels and LAM positive rate and ROC curve to determine ADA combined IFN-γ and LAM antigen for diagnosis of tuberculous pleurisy value.Results Tuberculous pleural effusion ADA and IFN-y levels were significantly higher than non-tuberculosis group[(53.88±14.39)U/L,(496.82±183.65)pg/ml vs.(15.07±12.36)U/L,(49.74±32.18)pg/ml,P<0.05];tuberculous and non-tuberculous group,the serum levels of ADA and.IFN-y no statistically significant difference[(24.31±7.85)U/L,(47.88±8.35)pg/ml vs.(22.94±7.60)U/L,(45.62±7.74)pg/ml,P>0.05];tuberculous pleural effusion and serum LAM antigen positive rate was significantly higher than that of non-tuberculous group(64.52%and 74.19%vs.2.78%and 5.56%,P<0.05).Pleural effusion ADA joint IFN-γ and LAM antigen in the diagnosis of tuberculous pleurisy high accuracy,the area under the ROC curve was 0.914(95%Cl 0.832-1.243).Conclusion Pleural effusion ADA joint IFN-y and LAM antigen detection for the diagnosis of tuberculous pleurisy with high accuracy,is worth promoting.更多还原