ADA、CRP、CEA和CA19-9对老年结核性、癌性胸腔积液的诊断价值分析

目的分析对于老年结核性、癌性胸腔积液的鉴别诊断,联合应用腺苷脱氨酶(ADA)、C-反应蛋白(CRP)、癌胚抗原(CEA)、糖类抗原19-9(CA19-9)四个指标的临床价值。方法分别选取我院治疗的肺结核和肺癌老年患者各40例,测定患者胸腔积液中ADA、CRP、CEA和CA19-9水平,比较分析四项单独应用以及联合应用对老年结核性和癌性胸腔积液鉴别的敏感度以及特异性等,从而分析其鉴别诊断的价值高低。结果癌性组CEA水平为(67.3±8.7)μg/ml,CA125为(63.6±15.9)μg/ml,而ADA及CRP水平明显低于结核组,差异显著,具有统计学意义。CEA、CA19-9对癌性胸腔积液诊断敏感性、特异性、准确性较高,ADA、CRP对结核性胸腔积液的敏感性、特异性、准确性较高。结论 ADA、CRP、CEA和CA19-9的检测水平在老年结核性、癌性胸腔积液的判别和诊断中有重要作用,可信度高,值得在临床推广。

Diagnostic value of ADA,CRP, CEA and CA19-9 in senile patients with tuberculosis and malignant pleural effusion

Objective To explore the value of ADA, CRP, CEA and CA19-9 in the diagnosis of senile patients with tuberculosis and malignant pleural effusion. Methods 40 elderly patients with pulmonary tuberculosis and lung cancer were selected in this study. The levels of ADA, CRP, CEA and CA19-9 were determined to explore the diagnostic value. Results In the cancer group, the level of CEA was 67.3±8.7 μg/ml, and the level of CA125 was 63.6±15.9 μg/ml. The levels of ADA and CRP were significantly lower in the cancer group than in the tuberculosis group （P〈0.05）. CEA and CA19-9 had a high sensitivity, specificity and accuracy in the diagnosis of malignant pleural effusion. ADA and CRP had a high sensitivity, specificity and accuracy in tuberculous pleural effusion. Conclusion The combined detection of ADA, CRP, CEA and CA19-9 has important significance in the differential diagnosis of senile tuberculosis and malignant pleural effusion, which is worth of widely clinical promotion.