摘要
目的研究白细胞介素(IL)-27、腺苷脱氨酶(ADA)及结核抗体(TB-Ab)三种生物标记物在结核性胸膜炎患者中的诊断价值。方法对2017年6月至2018年7月大连市结核病医院收治的74例结核性胸膜炎患者,45例非结核性胸膜炎患者(恶性胸腔积液30例,肺炎旁胸腔积液3例,心源性胸腔积液10例,肺栓塞1例,系统性红斑狼疮1例),采用酶联免疫吸附法检测两组患者血清和胸腔积液中IL-27、ADA及TB-Ab三种生物标记物的浓度,并进行统计学分析,应用受试者工作特征(ROC)曲线判断其对结核性胸腔积液的诊断价值。结果结核性胸膜炎患者血清及胸腔积液IL-27、ADA及TB-Ab三种生物标记物检测中,不论是血清还是胸腔积液,结核性胸膜炎患者均高于对照组[血清:(13.47 ± 5.29)U/L比(9.38 ± 5.29)U/L、28例比9例、(995.01 ± 377.82)ng/L(615.76 ± 253.28)ng/L,胸腔积液:(48.26 ± 13.75)U/L比(37.33 ± 25.42)U/L、28例比5例、(1 471.72 ± 581.15)ng/L比(648.16 ± 318.81)ng/L](P<0.05)。ROC曲线分析提示结核性胸膜炎患者血清IL-27、ADA及TB-Ab曲线下面积分别为0.820、0.744、0.589(P<0.05),胸腔积液曲线下面积分别为0.921、0.876、0.708(P<0.05)。联合检测IL-27、ADA ROC曲线下面积仍为0.921(P<0.05),但95%CI高于胸腔积液ADA及IL-27(0.804~0.930,0.857~0.962)。结论胸腔积液IL-27及ADA检测诊断结核性胸膜炎价值较大,联合检测胸腔积液IL-27、ADA可进一步提高诊断价值。
Objective To investigate the diagnostic value of IL-27, ADA and TB-Ab in TB pleurisy. Methods The data of 74 TB pleurisy cases and 45 non-TB pleurisy cases were screened randomly from June 2017 to July 2018 in Dalian Tuberculosis Hospital. Value of IL-27, ADA and TB-Ab in blood and pleural fluid of the two groups of cases was detected, and diagnostic value of these biomarkers in TB pleurisy was compared. Results The value of IL-27, ADA and TB-Ab in blood and pleural effusion of patients with TB pleurisy were higher than those of control group (P < 0.05). ROC curve analysis showed that areas under the blood IL-27, ADA and TB-Ab curves were 0.820, 0.744 and 0.589 (P < 0.05) respectively, while those under the pleural effusion curves were 0.921, 0.876 and 0.708 (P < 0.05) respectively. The area under the curve of IL-27 and ADA ROC curve was 0.921 (P < 0.05), but 95% CI was higher than that of pleural effusion ADA (0.804-0.930) and IL-27(0.857-0.962). Conclusions Detection of IL-27 and ADA in pleural effusion is of great value in the diagnosis of TB pleurisy. The combined detection of IL-27 and ADA in pleural effusion would improve the diagnostic value.
作者
宋晓东
路希维
徐齐峰
辛宝双
黄晓磊
张璐
张娜
董进
宋其生
Song Xiaodong;Lu Xiwei;Xu Qifeng;Xin Baoshuang;Huang Xiaolei;Zhang Lu;Zhang Na;Dong Jin;Song Qisheng(Department of Tuberculosis, Dalian Tuberculosis Hospital, Dalian 116033, China)
出处
《中国医师进修杂志》
2019年第6期514-517,共4页
Chinese Journal of Postgraduates of Medicine
基金
大连市医学科学研究计划项目(1711086).
关键词
结核
胸膜
胸腔积液
白细胞介素-27
腺昔脱氨酶
结核抗体
Tuberculosis
Pleura
Pleural effusion
Interleukin-27
Adenosine deaminase
Tuberculosis antibody
