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目的探讨胸腔积液中腺苷脱氨酶(ADA)、γ-干扰素(IFN-γ)和γ-干扰素诱导蛋白10(IP-10)水平对结核性胸膜炎的诊断价值。方法检测63例结核性胸膜炎及50例恶性胸腔积液患者胸腔积液中ADA、IFN-γ和IP-10的含量,经统计学分析,评价其对结核性胸膜炎的诊断价值。结果结核性胸腔积液中ADA、IFN-γ和IP-10含量明显高于恶性胸腔积液,差异有统计学意义(P<0.01)。ADA(以45U/L为临界值)诊断结核性胸膜炎的敏感度为71.4%,特异度为94.0%,诊断比值比39.17;IFN-γ(以138.5pg/ml为临界值)诊断结核性胸膜炎的敏感度为93.7%,特异度为82.0%,诊断比值比67.19;IP-10(以9.21μg/ml为临界值)诊断结核性胸膜炎的敏感度为85.7%,特异度为90.0%,诊断比值比54.00。3项指标联合检测时任何2项阳性诊断结核性胸膜炎的敏感度为95.2%,特异度为96.0%,诊断比值比72.16。结论联合检测ADA、IFN-γ和IP-10可提高结核性胸膜炎的诊断效能。
Objective To investigate the diagnostic value of ADA, IFN-γ and IP-10 in pleural effusion. Methods The levels of ADA, IFN-γ and IP-10 in pleural effusion of 63 patients with tuberculous pleurisy and 50 patients with malignant pleural effusion were measured. The diagnostic value of ADA, IFN-γ and IP-10 in tuberculous pleurisy was evaluated by statistical analysis. Results The levels of ADA, IFN-γ and IP-10 in tuberculous pleural effusion were significantly higher than those in malignant pleural effusion, the difference was statistically significant (P <0.01). ADA (45U / L as the cut-off value) had a sensitivity of 71.4%, a specificity of 94.0% and a diagnostic odds ratio of 39.17. IFN-γ (138.5 pg / ml as the cut-off value) diagnosed tuberculous pleurisy The sensitivity and specificity were 93.7%, 82.0% and 67.19, respectively. The sensitivity and specificity of IP-10 (9.21μg / ml) were 85.7% and 90.0%, respectively. The diagnostic odds ratio The sensitivity of any two positive diagnosis of tuberculous pleurisy was 95.2%, the specificity was 96.0% and the diagnostic odds ratio was 72.16 in the combined test of 54.00.3 items. Conclusion Combined detection of ADA, IFN-γ and IP-10 can improve the diagnostic efficacy of tuberculous pleurisy.