血管内皮生长因子和C反应蛋白对鉴别结核性和恶性胸腔积液的诊断价值

Diagnostic vaslues of vascular endothelital growth factor and Creactive protein in differentiating tuberculosis and malignant pleural effusion

目的探讨血管内皮生长因子(vascular endothelial growth factor,VEGF)和C反应蛋白(C-reactiveproteion,CRP)对鉴别结核性和恶性胸腔积液的临床价值。方法分别用酶联免疫吸附法(ELISA)和免疫透射比浊法检测两组患者血清和胸液中VEGF和CRP。结果恶性胸液患者血清和胸液中VEGF(0.194±0.254)μg/L与(2.824±11.441)μg/L,显著高于结核性胸液患者VEGF(0.099±0.309)μg/L与(0.099±0.143)μg/L(均P<0.001),胸液/血清VEGF比值在结核性(1.38±2.00)与恶性胸液(19.26±65.50)患者间比较差异有统计学意义(P<0.001);结核患者胸液中CRP(24.89±54.5)mg/L,显著高于恶性胸液患者(12.52±18.70)mg/L(P<0.001),胸液/血清CRP比值在结核性(0.66±1.33)和恶性胸液(0.44±0.97)患者差异有统计学意义(P<0.05)。联合检测胸液中VEGF、CRP、血清中VEGF三者水平诊断恶性胸液的灵敏度、特异度、准确度分别为83.3%、100.0%、92.1%。结论联合检测VEGF和CRP水平对鉴别结核性和恶性胸液具有重要的诊断价值。

Objective To explore the clinical validity of vascular endothelial growth factor （VEGF） and C- reactive protein （CRP） in discriminating tuberculosis pleuritis（TBP） and malignant pleural effusion （MPE）. Methods The pleural fluid and serum VEGF and CRP were measured by enzyme-linked immunosorbent assay and immunoturbidimetric method,respectively. Results VEGF levels in the serum and pleural effusion were significantly higher in the patients with malignant pleural effusion than those in the patients with tuberculosis pleural effusion （0. 194±0. 254）μg/L and （2. 824±11. 441） μg/L vs （0. 009±0. 309）μg/L and （0. 099±0. 143）μg/L（ P 〈0. 001）. The ratio of VEGF in pleural effusion to that in serum was significantly different between malignant pleural effusion and tuberculosis pleural effusion （19.26 ± 65.50） vs （1.38± 2.00） （ P 〈 0. 001 ） ; pleural effusion CRP levels were significantly higher in the patients with tuberculosis pleural effusion than those in the patients with malignant pleural effusion （24.89 ± 54.5） mg/L vs （12.52 ±18.70） rag/L（ P 〈0. 001）, the ratio of CRP in pleural effusion to that in serum was different between malignant pleural effusion and tuberculosis pleural effusion （0.44±0.97） vs （0.66± 1.33） （ P 〈0.05）. The sensitivity, specitivity and accuracy of combinative detecting VEGF and CRP in pleural effusion and VEGF in serum were 83.3%, 100.0%, 92.1%, respectively, for malignant pleural effusion. Conclusion The combinated detection of VEGF and CRP has diagnostic values in differentiating tuberculosis and malignant pleural effusion.