结核性胸腔积液患者胸水中白细胞介素-27、γ-干扰素、腺苷脱氨酶水平及临床意义

Levels of IL-27,IFN-γ and ADA in pleural effusion and their clinical significance in patients with tuberculous pleural effusion

目的探讨结核性胸腔积液患者胸水中白细胞介素 27(IL 27)、γ 干扰素(IFN γ)、腺苷脱氨酶(ADA)水平及临床意义。方法我院胸腔积液患者170例,其中结核性胸腔积液92例,恶性胸腔积液78例。在治疗前抽取胸水,检测IL 27、IFN γ、ADA水平,并绘制受试者工作特性曲线(ROC曲线)分析诊断结核性胸腔积液的价值,采用Pearson相关性分析IL 27与IFN γ、ADA的相关性。结果结核性胸腔积液组胸水中IL 27、IFN γ、ADA水平均高于恶性胸腔积液组(P<0.05);IL 27、IFN γ、ADA诊断结核性胸腔积液的AUC值分别为0.898、0.899、0.881;IL 27的cut off值为413.815 ng/L,敏感度、特异度为75.00%、96.20%;IFN γ的cut off值为144.255 ng/L,敏感度、特异度为80.40%、96.20%;ADA的cut off值为32.11 U/L,敏感度、特异度为69.60%、98.70%;IL 27水平与IFN γ、ADA水平呈正相关(P<0.05)。结论IL 27、IFN γ、ADA均可作为结核性胸腔积液鉴别诊断的可靠指标,且IL 27诊断效能更高。

Objective To investigate the levels and clinical significance of interleukin 27(IL 27),interferon γ(IFN γ)and adenosine deaminase(ADA)in pleural effusion of patients with tuberculous pleural effusion.Methods A total of 170 inpatients with pleural effusion including 92 cases of tuberculous pleural effusion and 78 cases of malignant pleural effusion were involved in the study.Pleural effusion was taken before treatment,and the levels of IL 27,IFN γand ADA were measured,and the receiver operating charac teristic curve(ROC curve)was drawn to analyze the clinical value of examination of tuberculous pleural effusion.Pearson correlation analysis was used to analyze the correlation between IL 27,IFN γand ADA.Results The levels of IL 27,IFN γand ADA in pleural ef fusion in the tuberculous pleural effusion group were significantly higher than those in the malignant pleural effusion group(P<0.05).The AUC values of IL 27,IFN γand ADA in the diagnosis of tuberculous pleural effusion were 0.898,0.899 and 0.881,respectively.The cut off value of IL 27 was 413.815 ng/L,and its sensitivity and specificity were 75.00%and 96.20%,respectively.The cut off val ue of IFN γwas 144.255 ng/L,and its sensitivity and specificity were 80.40%and 96.20%,respectively.The cut off value of ADA was 32 11U/L,and its sensitivity and specificity were 69.60%and 98.70%,respectively.Pearson correlation analysis showed that the level of IL 27 in pleural effusion was positively correlated with IFN γand ADA levels(P<0.05).Conclusion IL 27,IFN γand ADA can be used as reliable indicators for differential diagnosis of tuberculous pleural effusion,and IL 27 has a higher diagnostic efficacy.