细胞学图文报告中淋巴细胞百分比与积液腺苷脱氨酶联合检测对结核性胸腔积液的诊断价值

The diagnostic value of lymphocytes percentage in cytology graphic reports combined with effusion adenosine deaminase to tuberculous pleural effusion

目的探讨细胞学图文报告中淋巴细胞百分比与积液腺苷脱氨酶联合检测对结核性胸腔积液的诊断价值。方法回顾性分析2019年1月至2022年9月湖州市南浔区人民医院临床确诊为结核性胸腔积液的25例患者和非结核性胸腔积液的109例患者为研究对象,将前者设为试验组,将后者设为对照组。对两组患者胸腔积液进行生化指标检测和细胞学图文报告分析,经过统计学处理,评价单一检测和联合检测对结核性胸腔积液的诊断效能。结果试验组患者有核细胞计数、淋巴细胞百分比、总蛋白、乳酸脱氢酶、腺苷脱氨酶水平均明显高于对照组患者,两组差异均具有统计学意义(均P<0.001);试验组患者巨噬细胞百分比、间皮细胞百分比、葡萄糖水平均明显低于对照组患者,两组差异均具有统计学意义(均P<0.05);Logistic回归模型分析发现,淋巴细胞百分比、腺苷脱氨酶是结核性胸腔积液的独立预测因子。将淋巴细胞百分比、腺苷脱氨酶作为检验诊断指标,存在任何1项检验指标大于截断值时,曲线下面积为0.936,敏感性和特异性分别为100.00%、87.20%。结论细胞学图文报告中淋巴细胞百分比与积液腺苷脱氨酶联合检测明显提高了结核性胸腔积液的诊断能力。

Objective To explore the diagnostic value of lymphocytes percentage in cytology graphic reports combined with effusion adenosine deaminase to tuberculous pleural effusion.Methods From January 2019 to September 2022,25 patients with tuberculous pleural effusion(experimental group)and 109 patients with non-tuberculous pleural effusion(control group),were clinically diagnosed in Nanxun District People’s Hospital of Huzhou City,and biochemical index detection and cytology graphic report analysis of pleural effusion in both groups were performed,and statistical software was used for analysis to evaluate the diagnostic performance of single detection and combined examination.Results The levels of nucleocyte count,lymphocytes percentage,total protein,lactate dehydrogenase and adenosine deaminase in the experimental group were significantly higher than those in the control group,and the differences between the two groups were statistically significant(all P<0.001).The percentage of macrophages,mesothelial cells and glucose in the experimental group were significantly lower than those in the control group,and the differences were statistically significant(all P<0.05).Logistic regression model analysis found that lymphocytes percentage and adenosine deaminase were independent predictors of tuberculous pleural effusion.The percentage of lymphocytes and adenosine deaminase were used as diagnostic indicators,and when any one test index was greater than the cut-off value,the area under the curve was 0.936,and the sensitivity and specificity were 100.00%and 87.20%,respectively.Conclusions The combined detection of lymphocytes percentage in cytological graphic reports and effusion adenosine deaminase significantly improve the diagnostic ability of tuberculous pleural effusion.