联合测定分泌型白细胞蛋白酶抑制因子、干扰素-γ和腺苷脱氨酶在结核性胸腔积液中的诊断意义

Diagnostic significance of combination of secretory leukocyte protease inhibitor(SLPI), interferon-γ(IFN-γ) and adenosine deaminase(ADA) for tuberculous pleural effusion

目的:探讨联合测定不同病因胸腔积液中分泌型白细胞蛋白酶抑制因子(SLPI)、干扰素-γ(IFN-γ)和腺苷脱氨酶(ADA)的浓度对结核性胸腔积液的诊断价值。方法 :收集93例胸腔积液及其同源外周血,分为结核组、恶性组、细菌感染组及漏出液组。测定三种指标浓度,并对结果及意义进行分析。结果:结核组胸水SLPI、IFN-γ及ADA浓度较恶性组、感染组及漏出液组比较有统计学差异(P<0.05)。受试者工作特征曲线(ROC曲线)结果显示SLPI、IFN-γ和ADA对于诊断结核性胸腔积液均具有较高诊断效能;联合SLPI、IFN-γ和ADA能提高结核性胸腔积液诊断效能,其中以三者联合诊断效能最佳。结论:单独测定SLPI、IFN-γ及ADA均有助于诊断结核性胸腔积液,但联合测定更能提高诊断效能。

Objective To compare the diagnostic significance of pleural SLPI,IFN-γ and ADA for differentiating TPE from pleural effusions with the other etiologies. Methods Pleural effusion samples were obtained from 93 patients who were divided into the following groups ： tuberculous pleural effusion,malignant pleural effusion, bacterial pleural effusion and transudative pleural effusion. The pleural effusion and / or serum levels of SLPI, IFN-γ and ADA were determined. Results 1.The concentrations of SLPI, IFN-γ and ADA in tuberculous pleural effusion was higher than that in malignant group, bacterial group and transudative group. 2. The diagnostic value of SLPI, IFN-γ or ADA for the diagnosis of tuberculous PE is high respectively. The combinations of SLPI, IFN-γ and / or ADA gained the more valuable diagnostic performance. Conclusion Pleural SLPI, IFN-γ and ADA may be helpful for the differential diagnosis of tuberculous pleural effusion and the other pleural effusion. The combinations of SLPI or / and IFN-γ or / and ADA further increased diagnostic value.