【摘要】 目的分别检测结核性与恶性胸腔积液(以下简称胸液)中检测P-选择素、IL-1α、sFas、sFasL、AM(肾上腺髓质素)含量并与癌胚抗原(CEA)比较,探讨各检测方法及联合检测在结核性与恶性胸液鉴别诊断中的价值。方法在结核性与恶性胸液中,应用ELISA法检测P-选择素、IL-1α、sFas、sFasL的含量;用放射免疫法(RIA)分别检测AM与CEA含量,对所得数据进行统计学处理。结果(1)结核性胸液中P-选择素、IL-1α含量均明显低于恶性胸液组,分别为(t=8．71,P<0．01),(t= 6．80,P<0．01);(2)结核性胸液中sFas、sFasL含量均明显高于恶性胸液组,分别为(F=4．451,t= 6．422,P<0．001);(F=5．760,t=6．866,P<0．001);(3)结核性胸液中AM、CEA含量均明显低于恶性胸液组,分别为(t=7．49,P<0．05);(t=6．37,P<0．01)。结论P-选择素、IL-1α、sFas、sFasL与AM在对结核性与恶性胸液的鉴别诊断上,敏感性、特异性及临床诊断符合率均高于CEA,有较高的临床实用价值。ELISA法中以P-选择素为优,放免法以AM为优,联合检测可明显提高其临床诊断符合率。更多还原

【Abstract】 Objective To evaluate the diagnostic values and clinical significance of detecting P-selectin, IL-1α,soluble Fas,soluble FasL and adrenomedullin(AM)in pleural effusions in different tuberculous pleural effusions and malignant pleural effusions, and compare with CEA. Methods The level of P-selectin,IL-1α, soluble Fas, soluble FasL in tuberculous and malignant pleural effusions were determined by Enzyme-linked immunosorbent assay(ELISA) ,and that of AM and CEA were determined by radioimmunoassay(RIA). Results (1)The level of P-selectin and IL-1a in tuberculous pleural effusions was markedly lower than that in malignant pleural effusions( t = 8.71, P < 0.001) . (2)The level of sFasL and sFas in tuberculous pleural effusions was markedly higher than that in malignant pleural effusions ( t =6.80,P<0.001;F= 4.451,t= 6.422, P < 0.001) . (3)The level of AM and CEA in tuberculous pleural effussions was markedly lower than that in malignant pleural effusions(t = 7.491, P < 0.05; t = 6.37, P < 0.01). Conclusion The joint detection of P-selectin, IL-1α, sFas,sFasL, AM and CEA might be helpful to differential diagnosis of tuberculosis pleural effusion and malignant pleural effusion.更多还原