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目的:探讨细胞因子γ-干扰素(IFN-γ)、白介素-2(IL-2)、肿瘤坏死因子-α(TNF-α)和腺苷脱氨酶(ADA)对结核性和恶性胸腔积液的鉴别诊断的价值。方法:以2012年9月至2013年3月期间在青岛大学医学院附属医院呼吸科及青岛胸科医院未经治疗的胸腔积液患者为研究对象,其中恶性胸腔积液患者46例,结核性胸腔积液患者42例。采用双抗体夹心酶联免疫吸附测定法(ELISA)分别检测结核性和恶性胸腔积液患者中IFN-γ、IL-2、TNF-α及ADA的表达情况。并应用ROC曲线分析两组患者胸腔积液中IFN-γ、IL-2、TNF-α及ADA的表达差异及意义。结果:结核性胸腔积液组IFN-γ、IL-2、TNF-α及ADA的表达明显高于恶性胸腔积液组,差异有统计学意义(t=8.118、8.126、8.066、7.221;P=0.000、0.000、0.000、0.000,P<0.001);ROC曲线分析结果显示胸腔积液中IFN-γ、IL-2、TNF-α及ADA的诊断临界值为201.45 pg/mL、41.91 pg/mL、21.55 pg/mL、33.78 U/L;诊断敏感度分别为91.3%、93.5%、91.2%、89.1%;特异度分别为91.0%、92.1%、89.9%、90.1%。结论:胸腔积液中IFN-γ、IL-2、TNF-α及ADA的表达对结核性和恶性胸腔积液诊断与鉴别诊断具有重要参考价值。
Objective: To investigate the effects of IFN-γ, IL-2, TNF-α and ADA on tuberculous and malignant pleural effusions The value of liquid differential diagnosis. Methods: From September 2012 to March 2013 in the Department of Respiratory Medicine, Qingdao University Medical College Hospital and Qingdao Chest Hospital untreated patients with pleural effusion as the research object, of which 46 cases of malignant pleural effusion, tuberculous Pleural effusion in 42 patients. The expression of IFN-γ, IL-2, TNF-α and ADA in patients with tuberculous and malignant pleural effusion were detected by double antibody sandwich enzyme linked immunosorbent assay (ELISA). The difference and significance of IFN-γ, IL-2, TNF-α and ADA in pleural effusion between the two groups were analyzed by ROC curve. Results: The expression of IFN-γ, IL-2, TNF-α and ADA in tuberculous pleural effusion group was significantly higher than that in malignant pleural effusion group (t = 8.118,8.126,8.066,7.221; P = ROC curve analysis showed that the diagnostic threshold of IFN-γ, IL-2, TNF-α and ADA in pleural effusion were 201.45 pg / mL and 41.91 pg / mL, respectively. The diagnostic sensitivity was 91.3%, 93.5%, 91.2% and 89.1% respectively, and the specificity was 91.0%, 92.1%, 89.9% and 90.1% respectively. The diagnostic sensitivity was 21.55 pg / mL and 33.78 U / L, respectively. Conclusion: The expression of IFN-γ, IL-2, TNF-α and ADA in pleural effusion has important reference value for the diagnosis and differential diagnosis of tuberculous and malignant pleural effusion.