ADA、CysC在胸腔积液和血清中的比值对结核性胸腔积液的诊断价值研究

Study on the diagnostic value of the ratio of ADA and CysC in the Pleural effusion and serum for Tuberculous pleural effusion

目的探讨腺苷脱氨酶(ADA)、半胱氨酸蛋白酶抑制剂C(CysC)在胸腔积液和血清中的比值对结核性胸腔积液的临床诊断价值。方法随机抽取2014年上半年邯郸市传染病医院收治的结核性胸膜炎患者50例(结核组),肺癌胸腔积液患者20例(恶性组),肝性胸腔积液患者30例(对照组),检测胸腔积液中CysC(PCysC)、ADA(PADA)和血清的CysC(SCysC)、ADA(SADA)浓度,分别计算两种指标在胸腔积液与血清中含量的比值。结果 (1)分别比较PADA、SADA,SCysC、PCysC,PCysC/SCysC和PADA/SADA 3组结果,差异均有统计学意义(P<0.05)。(2)依据ROC曲线确立PADA/SADA和PCysC/SCysC的临界值分别为1.58和2.30,PADA/SADA和PCysC/SCysC曲线下面积分别为0.880和0.786。结论 PADA/SADA和PCysC/SCys对结核性胸腔积液的诊断价值优于单纯使用PADA、SADA、PCysC和SCysC,可作为鉴别诊断结核性胸腔积液的指标应用于临床。

Objective To investigate the clinical value of the ratio of ADA and CysC in the Pleural effusion and serum for the diagnosis of Tuberculous pleural effusion. Methods In the first half of 2014,50 cases from a random sample of patients with tuberculous pleurisy admitted in our hospital were chosen as tuberculosis group, 20 cases of patiente with lung cancer pleural effusion as malignant group and 30 cases of patiente with hepatic hydrothorax as control group. The concentrations of CysC and ADA in the pleural effusion and serum were detected,and the ratios of these two indexes in the pleural effusion and serum were calculated. Results （l）The results in three groups including PADA and SADA,SCysC and PCysC,PCysC/SCysC and PADA/SADA were compared,and the differences were statistically significant （P〈0.05）. （2） According to the ROC curve,the critical value of PADA/SA-DA and PCysC/SCysC were set as 1. 58 and 2. 30, respectively, and area under the curve of PADA/SADA and PCysC/SCysC were 0. 880 and 0. 786 respectively. Conclusion The diagnostic value of PADA/SADA and PCysC/SCys for tuberculous pleural effusion is higher than that of PADA,SADA,PCysC or SCysC alone, which can be used for the differential diagnosis of tuberculous pleural effusion index for clinical application.