胸腔积液IGRA与ADA、ESR联合检测对结核性胸膜炎预后的评估价值分析

目的探讨胸腔积液γ干扰素释放试验(IGRA)与腺苷脱氨酶(ADA)、红细胞沉降率(ESR)联合检测对结核性胸膜炎预后的评估价值。方法回顾性选择2017年10月至2019年10月秦皇岛市第三医院收治的198例结核性胸膜炎患者为研究对象,根据其预后情况分为预后不良组(n=30)与预后良好组(n=168)。比较两组胸腔积液IGRA、ADA、ESR检测结果,分析预后不良组患者胸腔积液IGRA、ADA、ESR之间相关性,分析胸腔积液IGRA、ADA、ESR对结核性胸膜炎预后的预测价值。结果预后不良组胸腔积液ADA、ESR水平、IGRA阳性率显著高于预后良好组(P<0.05);预后不良组患者胸腔积液IGRA与ADA、ESR呈正相关(P<0.05),ADA与ESR呈正相关(P<0.05);胸腔积液ADA对结核性胸膜炎预后不良的预测价值明显优于胸腔积液ESR(P<0.05);胸腔积液IGRA对结核性胸膜炎预后不良的预测价值明显优于胸腔积液ADA(P<0.05);胸腔积液IGRA、ADA、ESR联合检测对结核性胸膜炎预后不良的预测价值明显优于各项单独检测(P<0.05)。结论胸腔积液IGRA与ADA、ESR联合检测预测结核性胸膜炎预后的准确性较高,对结核性胸膜炎的临床治疗有一定指导意义。

Value of combined detection of pleural effusion IGRA,ADA and ESR in evaluating the prognosis of tuberculous pleurisy

Objective To investigate the value of combined detection of pleural effusion interferon gamma release assay(IGRA),adenosine deaminase(ADA)and erythrocyte sedimentation rate(ESR)in evaluating the prognosis of tuberculous pleurisy.Methods 198 cases of patients with tuberculous pleurisy in our hospital from October 2017 to October 2019 were retrospectively selected,and divided into two groups according to their prognosis: the poor prognosis group(n=30)and the good prognosis group(n=168).Pleural effusion IGRA,ADA,ESR levels were compared between the two groups,and the correlation within three indicators in the poor prognosis group was also analyzed.Then the prognostic value of pleural effusion IGRA,ADA and ESR in tuberculous pleurisy was analyzed.Results The level of ADA,ESR,the positive rate of IGRA in pleural effusion of the poor prognosis group was significantly higher than that of the good prognosis group(P<0.05);Pleural effusion IGRA was positively correlated with ESR in the poor prognosis group(P<0.05).Pleural effusion ADA was positively correlated with ESR in the poor prognosis group(P<0.05).Pleural effusion IGRA had the highest predictive value for poor prognosis of tuberculous pleurisy,followed by ADA and ESR,with statistically significant difference(P<0.05).The predictive value of combined detection of IGRA,ADA and ESR for poor prognosis of tuberculous pleurisy was significantly higher than that of single detection(P<0.05).Conclusion The accuracy of pleural effusion IGRA combined with ADA and ESR in predicting the prognosis of tuberculous pleurisy is high,and it has certain guiding significance for the clinical treatment of tuberculous pleurisy.