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目的探讨联合检测血清和胸腔积液降钙素原(PCT)、腺苷脱氨酶(ADA)对结核性胸腔积液的诊断价值。方法 128例胸腔积液患者分为3组:结核性52例为结核组,肺炎旁积液22例为肺炎组,恶性40例和心衰性14例为对照组。测定各组患者血清和胸腔积液的PCT、ADA水平。结果结核组、肺炎组和对照组间血清PCT水平差异无统计学意义(P>0.05),结核组和肺炎组胸腔积液中PCT的表达均较对照组明显升高(均P<0.05)。结核组血清和胸腔积液中ADA水平较肺炎组和对照组显著升高(P<0.01)。受试者工作曲线(ROC曲线)分析胸腔积液ADA/血清ADA值(P/S值)>1.27诊断结核性胸腔积液的敏感度和特异度最佳,分别为92.3%和100%。结论联合检测胸腔积液中PCT与ADA的表达可极大提高结核性胸腔积液诊断的敏感性和特异性。
Objective To explore the diagnostic value of combined detection of serum and pleural effusion procalcitonin (PCT) and adenosine deaminase (ADA) in patients with tuberculous pleural effusion. Methods 128 cases of pleural effusion were divided into 3 groups: tuberculous 52 cases of tuberculosis group, pneumonia paraplegia 22 cases of pneumonia group, 40 cases of malignant and 14 cases of heart failure as control group. The levels of PCT and ADA in serum and pleural effusion in each group were determined. Results There was no significant difference in serum PCT levels between tuberculosis group, pneumonia group and control group (P> 0.05). The expression of PCT in tuberculosis group and pneumonia group was significantly higher than that in control group (all P <0.05). ADA levels in tuberculosis group serum and pleural effusion were significantly higher than those in pneumonia group and control group (P <0.01). Receiver operating curve (ROC curve) analysis of pleural effusion ADA / serum ADA value (P / S value)> 1.27 The sensitivity and specificity of diagnosis of tuberculous pleural effusion were 92.3% and 100% respectively. Conclusions Combined detection of PCT and ADA expression in pleural effusion can greatly improve the sensitivity and specificity of the diagnosis of tuberculous pleural effusion.