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目的:探讨胸水中脂多糖(LPS)、白细胞介素35(IL-35)、维甲酸相关孤儿受体α(RORα)在结核性胸腔积液中的表达变化及临床意义。方法:采用回顾性研究方法，选择2017年1月至2020年1月襄阳市中心医院收治的79例结核性胸膜炎患者为结核组，66例恶性胸膜炎患者为恶性组。比较2组胸水LPS、IL-35、RORα水平，采用spearman相关分析胸水LPS、IL-35、RORα水平与结核性胸膜炎的相关性，采用多因素logistic回归分析结核性胸膜炎的影响因素，采用受试者工作特征曲线分析胸水LPS、IL-35、RORα对结核性胸膜炎与恶性胸膜炎的鉴别诊断价值。结果:结核组胸水LPS、IL-35、RORα水平显著高于恶性组(n t值分别为2.691、2.908、6.017，n P值均<0.05)；胸水LPS、IL-35、RORα水平与结核性胸膜炎均呈正相关(n r值分别0.375、0.583、0.604，n P值均<0.05)；胸水LPS、IL-35、RORα水平升高是结核性胸膜炎的危险因素(n P值均<0.05)；胸水LPS对结核性胸膜炎与恶性胸膜炎的准确性明显高于胸水RORα(n P<0.05)；胸水IL-35对结核性胸膜炎与恶性胸膜炎的准确性明显高于胸水LPS(n P<0.05)；胸水LPS、IL-35、RORα联合检测对结核性胸膜炎与恶性胸膜炎的准确性明显高于各项指标单独检测(n P<0.05)。n 结论:胸水LPS、IL-35、RORα在结核性胸膜炎患者中呈高水平，胸水LPS、IL-35、RORα联合检测在结核性胸膜炎与恶性胸膜炎的鉴别诊断中价值较高，有望在临床推广。“,”Objective:To investigate the expressions and clinical significance of lipopolysaccharide (LPS), interleukin 35 (IL-35) and retinoic acid-related orphan receptor α (RORα) in tuberculous pleural effusion.Methods:In a retrospective study, 79 patients with tuberculous pleurisy (tuberculosis group) and 66 patients with malignant pleurisy (malignant group) in Xiangyang Central Hospital from January 2017 to January 2020 were enrolled.The levels of LPS, IL-35, and RORα in pleural effusion were detected, and their correlation with tuberculous pleurisy was determined by spearman correlation analysis.The influencing factors of tuberculous pleurisy were analyzed by multivariate logistic regression.The diagnostic value of LPS, IL-35 and RORα in pleural fluid for tuberculous pleurisy and malignant pleurisy was analyzed by receiver operating characteristic curve.Results:The levels of LPS, IL-35 and RORα in pleural effusion of tuberculosis group were significantly higher than those of malignant group (n t=2.691, 2.908, 6.017, all n P<0.05). The levels of LPS, IL-35, RORα in pleural effusion were positively correlated with tuberculous pleurisy (n r=0.375, 0.583, 0.604, all n P<0.05). Elevated levels of LPS, IL-35 and RORα in pleural effusion were risk factors for tuberculous pleurisy (alln P<0.05). The accuracy of LPS in pleural effusion for tuberculous pleurisy and malignant pleurisy was significantly higher than that of RORα(n P<0.05). The accuracy of IL-35 in pleural effusion for tuberculous pleurisy and malignant pleurisy was significantly higher than that of LPS (n P<0.05). The accuracy of combined detection of LPS, IL-35 and RORα in pleural effusion for tuberculous pleurisy and malignant pleurisy was significantly higher than that of single detection (n P<0.05).n Conclusions:The levels of LPS, IL-35, and RORα in pleural effusion are elevated in patients with tuberculous pleurisy.The combined detection of the three indexes has high value in the differential diagnosis of tuberculous pleurisy and malignant pleurisy, which is expected to be recommended in clinical practice.