ADA、CRP、IFN-γ联合检测对结核性胸膜炎的诊断价值

目的 探讨血清腺苷脱氨酶(ADA)活性、CRP含量和IFN-γ含量联合检测对结核性胸膜炎的诊断价值.方法 检测59例结核性胸膜炎患者(结核组)、20例恶性胸水患者(恶性胸水组)以及12例其他渗出性胸水患者(其他组)胸水和血清中的ADA活性、CRP含量以及IFN-γ含量,经统计学处理后,评价各项指标诊断结核性胸膜炎的灵敏度、特异度及临床诊断符合率.结果 结核组胸水中ADA活性、CRP含量、IFN-γ含量分别为(50.98±13.07)U/L、(142.90±51.42)mg/L、(139.46±70.43)ng/L,与恶性胸水组和其他组比较差异均有统计学意义,P＜0.05或＜0.1.ADA以45 U/L为临界值,诊断结核性胸膜炎的灵敏度为80.4%,特异度为96.9%,临床诊断符合率为86.4%;CRP以110 mg/L为临界值,诊断结核性胸膜炎的灵敏度为78.6%,特异度为81.2%,临床诊断符合率为79.5%;IFN-γ以100 ng/L为临界值,诊断结核性胸膜炎的灵敏度为83.9%,特异度为93.8%,临床诊断符合率为87.5%.三项指标联合检测,诊断结核性胸膜炎的灵敏度为94.5%,特异度为97.8%,临床诊断符合率为94.3%.结论 ADA活性、IFN-γ含量和CRP含量联合检测可极大地提高结核性胸膜炎的诊断效能.

The diagnostic values of combined detecting of adenosine deaminase ,C-reactive protein and interferon-γ for tuberculous pleurisy

Objective To explore the diagnostic values of adenosine deaminase (ADA) activity,C-readive protein (CRP) content and IFN-γ content for tuberculous pleurisy.Methods Fifty-nine cases with tuberettlous pleurisy,20 cases malignant tumor with pleural fluid and 12 cases of the other pleural fluid were studied,ADA activity,CRP content and IFN-γ content of pleurnl fluid and serum were detected in those patients.Results The pleural fluid activity of ADA[(50.98±13.07)U/L],content of CRP[(142.90±51.42)mg/L]and content of IFN-γ [(139.46±70.43)ng/L] in tuberculous pleurisy were significantly higher than those in malignant tumor and the other pleural fluid (P＜0.05 or＜0.01).When regarded 45 U/L as critical value of ADA in tnberculous pleurisy,the sensitive rate,special rate and clinical diagnose accordance rate were 80.4%,96.9%and 86.4%respectively,110,mg/L as critical value of CRP,they were 78.6%,81.2%,and 79.5% respectvely.100 ng/L as critical value of IFH-γ,they were 83.9%,93.8% and 87.5% respeelively.Combined detection of them in tuberculous pleurisy,the sensitive tale,specinl rate and clinical diagnose accordance rate were 94.5%,97.8% and 94.3% respectively.Conclusion Combined delection of ADA activity,CRP content and IFN-γ content in pleural fluid can improve the diagnosis of tuberculous pleurisy.