胸腔积液CEA、ADA联合外周LDH对结核性胸膜炎的诊断价值分析

Diagnostic Value of Pleural Effusion CEA,ADA Combined with Peripheral LDH for Tuberculous Pleurisy

目的:分析胸腔积液癌胚抗原(CEA)、腺苷脱氨酶(ADA)联合LDH对结核性胸膜炎的诊断价值。方法:收集2016年12月~2019年3月在某院收治的119例胸腔积液患者作为本次研究对象,经确诊有70例患者为结核性胸膜炎组,49例患者为非结核性胸膜炎组,研究患者的胸腔积液癌胚抗原(CEA)、腺苷脱氨酶(ADA)以及LDH,LDH、胸腔积液CEA、ADA的单一检测以及三者试验联合检测的敏感性与特异性。结果:结核性胸膜炎组患者胸腔积液CEA水平明显低于非结核性胸膜炎组(P<0.05),阴性率明显高于非结核性胸膜炎组(97.14%vs 14.29%,P<0.05);结核性胸膜炎组患者胸腔积液ADA水平明显高于非结核性胸膜炎组(P<0.05),且阳性率也明显高于非结核性胸膜炎组(64.29%vs 0%,P<0.05);胸腔积液CEA、ADA与外周血LDH联合检测结核性胸膜炎患者的敏感性、特异性、准确率、阳性预测值以及阴性预测值均高于其他单一检测法(P<0.05)。结论:胸腔积液CEA、ADA联和外周LDH特异度较高,能够明显提高结核性胸膜炎患者诊断准确率,值得临床应用。

Objective:To analyze the diagnostic value of pleural effusion carcinoembryonic antigen(CEA),adenosine deaminase(ADA)combined LDH for tuberculous pleurisy.Methods:119 patients with pleural effusion treated in a hospital from december 2016 to march 2019 were collected as the subjects of this study.70 patients were diagnosed as tuberculous pleurisy group and 49 as non-tuberculosis pleurisy group.The pleural effusion carcinoembryonic antigen(CEA),adenosine deaminase(ADA)and LDH of patients were studied,and the sensitivity and specificity of single detection and combined detection of LDH,pleural effusion CEA and ADA in patients were also studied.Results:The level of pleural effusion CEA in the tuberculous pleurisy group was significantly lower than that in the non-tuberculosis pleurisy group(P<0.05%),and the negative rate was significantly higher than that in the non-tuberculosis pleurisy group(97.14%vs 14.29%,P<0.05).The level of pleural effusion ADA in tuberculous pleurisy group was significantly higher than that in non-tuberculosis pleurisy group(P<0.05%),and the positive rate was also significantly higher than that in non-tuberculosis pleurisy group(64.29%vs 0%,P<0.05).The sensitivity,specificity,accuracy,positive predictive value,and negative predictive value of patients with tuberculous pleurisy detected by pleural effusion CEA、ADA combined with peripheral blood LDH were higher than those of other single detection methods(P<0.05).Conclusion:The high specificity of pleural effusion CEA、ADA and peripheral LDH can obviously improve the diagnostic accuracy of patients with tuberculous pleurisy,which is worthy of clinical application.