胸液γ-干扰素和α-肿瘤坏死因子检测对结核性胸膜炎诊断价值的探讨

Significance of detecting interferon (IFN) gamma and tumour necross factor(TNF) alpha concentrations in pleural effusion in the diagnosis of tuberculous pleurisy

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 eveluate the concentration of inferon(IFN) gamma and tumour necrosis factor(TNF) alpha in pleural effision in the diagnosis of tuberculous pleurisy.Method IFN γ and TNF α of serum and pleural effusion in 41 patients with tuberculous pleurisy,40 patients with malignant pleurisy and 41 healthy individuals serum were detected by ELISA method.Result The concentration of IFN γ and TNF α were much higher in tuberculous pleurisy(427 3±56 8、184 7±64 7),than malignant pleurisy(45 6±20 3,50 5±18 7) P <0 01.The serum concertration of them were low in two groups( P >0 05).The sensitivity,specificity,accuracy of IFN γ in the diagnosis of tuberculosis pleurisy were 100 0%,97 5%,98 8%,respectively.Similarly,those of TNF α for the diagnosis were 87 8%,90 0%,88 9%,respectively.Conclusion Our results indicate that simultaneous measurement of IFN γ and TNF α in pleural effusion might be helpful for the diagnosis of tuberculous pleurisy.