胸腔积液中IL-27及Gene Xpert MTB/RIF联合检测有助于结核性胸膜炎的快速诊断

Pleural effusion IL-27 combined with Gene Xpert MTB/RIF expression in rapid diagnosis of tuberculous pleurisy

目的:观察胸腔积液中白介素-27(IL-27)、结核杆菌利福平耐药基因(Gene Xpert MTB/RIF)表达水平在结核性胸膜炎快速诊断中的应用价值。方法:回顾性分析128例结核性胸膜炎患者的临床资料,另选择同期收治的128例非结核性胸膜炎胸腔积液患者为对照(恶性胸腔积液组、类肺炎性胸腔积液组与漏出性胸腔积液组分别61例、36例与31例),采用酶联免疫吸附法检测患者胸腔积液中IL-27水平,并予以Gene Xpert MTB/RIF试验,以临床综合诊断结果为金标准,评估IL-27、Gene Xpert MTB/RIF水平在结核性胸膜炎诊断中的应用价值。结果:结核性胸膜炎组胸腔积液中IL-27水平显著高于恶性胸腔积液组、类肺炎性胸腔积液组与漏出性胸腔积液组(F=112.944,P均<0.05);IL-27诊断结核性胸膜炎的AUC值为0.875,敏感度为73.43%、特异性为85.16%;Gene Xpert MTB/RIF诊断结核性胸膜炎敏感度、特异性分别为77.34%、100.00%;两者联合诊断结核性胸膜炎的敏感度为86.72%,特异性为100.00%。结论:胸腔积液中IL-27、Gene Xpert MTB/RIF水平对结核性胸膜炎的诊断有一定意义,联合检测有助于结核性胸膜炎的诊断。

Objective:To observe the application value of pleural effusion interleukin-27(IL-27)and Gene Xpert MTB/RIF expression levels in rapid diagnosis of tuberculous pleurisy.Methods:The clinical data of 128 patients with tuberculous pleurisy were retrospectively analyzed,and a total of 128 patients with pleural effusion but without tuberculous pleuritis who were admitted to the hospital during the same period were selected as controls.The patients with tuberculous pleurisy were divided into malignant pleural effusion group(61 cases),pneumonia-like pleural effusion group(36 cases)and transudatory pleural effusion group(31 cases).Pleural effusion IL-27 levels were detected by enzyme linked immunosorbent assay,and Gene Xpert MTB/RIF test was performed.Taking clinical comprehensive diagnosis results as the golden standard,the application value of IL-27 and Gene Xpert MTB/RIF in rapid diagnosis of tuberculous pleurisy was evaluated.Results:The pleural effusion IL-27 level in the tuberculous pleurisy group was significantly higher than in the malignant pleural effusion group,pneumonia-like pleural effusion group and transudatory pleural effusion group(F=112.944,all P<0.05).The AUC value,sensitivity and specificity of IL-27 to diagnose tuberculous pleurisy were 0.875,73.43%and 85.16%,respectively.The sensitivity and specificity of Gene Xpert MTB/RIF were 77.34%and 100.00%respectively.The sensitivity and specificity of the Gene Xpert MTB/RIF in combination with IL-27 to diagnose tuberculous pleurisy were 86.72%and 100.00%respectively.Conclusion:Both IL-27 and Gene Xpert MTB/RIF can help diagnose tuberculous pleurisy,and combination of them is conducive to the diagnosis of tuberculous pleurisy.