目的检测结核性胸膜炎及恶性胸膜炎患者血清与胸液的γ干扰素和α肿瘤坏死因子水平，探讨对结核性胸膜炎诊断的临床价值。方法采用酶联免疫吸附法（ＥＬＩＳＡ）检测４１例结核性胸膜炎、４０例恶性胸膜炎患者血清及胸液和４１例健康对照组血清的γ干扰素和α肿瘤坏死因子水平。结果结核性胸膜炎患者两者含量（４２７３±５６８、１８４７±６４７ｐｇ／ｍｌ）明显高于恶性胸膜炎组（４５６±２０３、５０５±１８７）（Ｐ＜００１），且重叠性很小；而两组血清含量很低并相近，与健康对照组比较无显著差异（Ｐ＞００５）。γ干拢素和α肿瘤坏死因子作为诊断结核性胸膜炎的敏感性、特异性、准确性分别为１０００％、９７５％、９８８％及８７８％、９００％、８８９％。结论检测胸液γ干扰素和α肿瘤坏死因子对诊断结核性胸膜炎有较大的辅助意义。 Objective To detect the levels of interferon-γ and tumor necrosis factor-α in serum and pleural fluid in patients with tuberculous pleurisy and malignant pleurisy, and to explore the clinical value of tuberculous pleurisy. Methods Serum levels of interferon-γ and tumor necrosis factor α (TNF-α) in 41 cases of tuberculous pleurisy, 40 cases of malignant pleurisy, serum and pleural effusion and 41 healthy controls were detected by enzyme linked immunosorbent assay (ELISA). Results Both tuberculous pleurisy patients (4273 ± 568, 1847 ± 647 pg / ml) were significantly higher than those in malignant pleurisy group (456 ± 203, 505 ± 187) (P <001), and the overlap was very small. However, the serum levels of the two groups were very low and similar, showing no significant difference from the healthy controls (P> 005). The sensitivity, specificity and accuracy of γ-glucan and α-tumor necrosis factor were 1000%, 975%, 988% and 878%, 900 %, 88  9%. Conclusion Detection of pleural effusion IFN-γ and TNF-α for the diagnosis of tuberculous pleurisy have a greater secondary significance.