腺苷脱氨酶与肿瘤坏死因子-α和白细胞介素-12检测在诊断结核性胸腔积液中临床价值的比较

Comparison of clinical values of adenosine deaminase,tumor necrosis factor-α and interleukin-12 in diagnosing tuberculous pleural effusion

目的通过对结核性胸腔积液中腺苷脱氨酶(ADA)、肿瘤坏死因子-α(TNF-α)、白细胞介素12-(IL-12)浓度的测定,比较ADA、TNF-α和IL-12在结核性胸腔积液诊断中的临床价值。方法以2008年6月至2011年10月在东莞康华医院确诊的73例胸腔积液患者为研究对象,其中结核性胸腔积液45例、恶性胸腔积液28例,分别留取相应胸腔积液标本,采用酶法和双抗体夹心酶联免疫吸附试验检测各组的ADA、TNF-α及IL-12含量。结果结核性胸腔积液组的ADA、TNF-α及IL-12含量明显高于恶性胸腔积液组,差异有统计学意义(P<0.01),ROC曲线表明对结核性胸腔积液的诊断价值依次为TNF-α、ADA、IL-12。结论胸腔积液中ADA、TNF-α及IL-12含量测定是诊断结核性胸腔积液重要的指标,联合检测更有助于结核性胸腔积液的诊断与鉴别诊断。

Objective To compare the clinical values of ADA,TNF-a and IL-12 in the diagnosis of tuberculous pleural effusion. Methods The chest fluid specimens in 73 patients with pleural effusion,including 45 cases of tuber- culous pleural effusion and 28 cases of malignant pleural effusion, in our hospital from June 2008 to October 2011 were detected the ADA, TNF-α and IL-12 levels by the enzymatic method and the antibody-sandwich ELISA method. Results The ADA,TNF-αand IL-12 levels in the tuberculous pleural effusion group were all significantly higher than those in the malignant pleural effusion group with statistical differences（P〈0. 001 ,P〈0.01）. The ROC curve revealed that the diagnostic values to tuberculous pleural effusion were in turn TNF-α〉ADA〉IL-12. Conclusion The determination of chest fluid ADA,TNF-α and IL 12 contents is an important indicator in the diagnosis of tuber- culous pleural effusion. Combined determination of ADA,TNF-α and IL-12 is conducive to diagnosis and differential diagnosis of tuberculous pleural effusion.