摘要
目的探讨结核性渗出性胸膜炎患者血浆纤维蛋白原(FIB)、D-二聚体(D-D)的表达水平,并探讨FIB、D-D在结核性渗出性胸膜炎中的临床意义。方法选择2016年1月～2018年9月我院就诊且经胸腔镜确诊的134例胸腔积液患者;采集研究对象的空腹静脉血液,检测其血浆FIB、D-D表达水平,以病理诊断结果为参照,计算和比较FIB、D-D对结核性渗出性胸膜炎的诊断灵敏度、特异度、准确率。根据病理诊断结果将胸腔积液患者分为结核性渗出性胸膜炎组、恶性胸腔积液组,比较结核性渗出性胸膜炎组、恶性胸腔积液组的血浆FIB、D-D表达水平及阳性率。采用皮尔逊相关系数分析法,分析血浆FIB、D-D与结核性渗出性胸膜炎的相关性。结果 (1)134例胸腔积液患者中,经病理诊断后确诊86例结核性渗出性胸膜炎患者、48例恶性胸腔积液患者,以病理诊断结果为参照,FIB对结核性渗出性胸膜炎的诊断灵敏度、特异度、准确率分别为77.91%、56.25%、70.15%,D-D的灵敏度、特异度、准确率分别为90.70%、41.67%、73.13%。(2)结核性渗出性胸膜炎组的血浆FIB、D-D表达水平均高于恶性胸腔积液组(P <0.05),其FIB阳性率(77.91%)、D-D阳性率(90.70%)均高于恶性胸腔积液组的43.75%、60.42%(P <0.05)。(3)经相关性分析,血浆FIB、D-D与结核性渗出性胸膜炎均呈正相关。结论结核性渗出性胸膜炎患者的血浆FIB、D-D表达水平普遍高于恶性胸腔积液患者,临床上可通过检测血浆FIB、D-D来鉴别区分结核性渗出性胸膜炎与恶性胸腔积液。
Objective To understand the expression level of plasma fibrinogen(FIB) and D-dimer(D-D) in patients with tuberculous exudative pleurisy and to explore the clinical significance of FIB and D-D in tuberculous exudative pleurisy. Methods 134 patients with pleural effusion diagnosed by thoracoscopy who were treated in our hospital from January 2016 to September 2018 were selected.Fasting venous blood samples were collected to detect the expression level of plasma FIB and D-D.Based on the pathological diagnosis results,the diagnostic sensitivity,specificity and accuracy of FIB and D-D for tuberculous exudative pleurisy were calculated and compared.According to the results of pathological diagnosis,patients with pleural effusion were divided into the tuberculous effusive pleurisy group and the malignant pleural effusion group.The expression level and positive rate of plasma FIB and D-D in the tuberculous effusive pleurisy group and the malignant pleural effusion group were compared.Pearson correlation coefficient analysis was used to analyze the relationship between plasma FIB,D-D and tuberculous exudative pleurisy. Results(1)In 134 patients with pleural effusion, there were 86 cases of tuberculous exudative pleurisy and 48 cases of malignant pleural effusion by pathological diagnosis.With pathological diagnosis results as reference,the sensitivity,specificity and accuracy of FIB in the diagnosis of tuberculous exudative pleurisy were 77.91%,56.25% and 70.15% respectively.Those of the D-D were 90.70%,41.67% and 73.13% respectively.(2)The expression levels of plasma FIB and D-D in tuberculous exudative pleurisy group were higher than those in malignant pleural effusion group(P < 0.05).The positive rates of FIB and D-D in tuberculous exudative pleurisy group were 77.91% and 90.70%respectively,higher than those of malignant pleural effusion group 43.75% and 60.42%(P < 0.05).(3)By correlation analysis,plasma FIB and D-D were both positively correlated to tuberculous exudative pleurisy. Conclusion The expression levels of plasma FIB and D-D in patients with tuberculous exudative pleurisy are generally higher than those in patients with malignant pleural effusion.Clinically,plasma FIB and D-D can be used to distinguish tuberculous exudative pleurisy from malignant pleural effusion.
作者
薛永新
郭俊华
张倩云
XUE Yongxin;GUO Junhua;ZHANG Qianyun(Department of Respiratory Medicine,Meizhou People's Hospital,Meizhou 514031,China)
出处
《中国医药科学》
2019年第7期9-11,22,共4页
China Medicine And Pharmacy
