白介素27联合腺苷脱氨酶诊断结核性胸腔积液的临床价值

The clinical value of combined interleukin-27 and adenosine deaminase for the diagnosis of tuberculous pleurisy

目的探讨白介素-27(IL-27)联合腺苷脱氨酶(ADA)在结核性胸腔积液中的临床价值。方法选取98例结核性胸腔积液患者、50例恶性胸腔积液患者及38例肺炎旁胸腔积液,测定积液中IL-27、ADA含量,分析比较其对结核性胸腔积液的诊断效率。结果结核性胸腔积液中IL-27、ADA水平均显著高于恶性胸腔积液组及肺炎旁胸腔积液,差异有统计学意义(P<0.01),IL-27、ADA诊断结核性胸腔积液的ROC曲线下面积分别为98.1%、89.7%;胸水中IL-27的最优截断点为300.8ng/L,敏感度为96.6%,特异性为97.2%;ADA的最优截断点为24.5U/L,敏感度为93.21%,特异性为85.9%,胸腔积液中IL-27含量与ADA含量呈正相关(r值分别为0.149,0.095,P<0.01)。结论 IL-27联合ADA可作为结核性胸腔积液和恶性胸腔积液鉴别诊断的可靠指标。

Objective To investigate the clinical value of combined interleukin-27（IL-27） and adenosine deaminase（ADA） in tuberculous pleural effusion. Methods 98 patients with tuberculous pleural effusion（tuberculosis group）,50 cases of malignant pleural effusion（malignant group） and 38 cases of pneumoniae pleural effusion were selected. Tuberculous pleural effusion was collected on the first day after admission. IL-27,ADA were measured and the results were compared. Results The levels of IL-27 and ADA in tuberculous pleural effusion were significantly higher than those in malignant pleural effusion（P〈0.01）. The area under the ROC curve of IL-27 and ADA in diagnosing tuberculous pleural effusion was 98.1% and 89.7%,respectively. The area of ADA in pleural effusion was the most significant（P〈0.01）. The specific cutoff of ADA was 24.5 U/L,the sensitivity was 93.21% and the specificity was 85.9%. Whilethe IL-27 in the pleural effusion was 300.8 ng/L,the sensitivity was 96.6% and the specificity was 97.2%（P〈0.01）. Conclusion IL-27 combined with ADA can be used as a reliable index for differential diagnosis of tuberculous pleural effusion and malignant pleural effusion.