摘要
目的探讨联合检测细胞角蛋白19可溶性片段(CYFRA21-1)和胸水γ干扰素(IFN-γ)对结核性胸膜炎的早期诊断价值。方法对筛选出的89例不同成因胸腔积液患者的血清、胸水CYFRA21-1以及胸水IFN-γ浓度水平进行分析,同时应用ROC曲线分析取得最佳界限值及检测的敏感度和特异度。结果血清CYFRA21-1浓度在恶性组高于结核性组和漏出液组(P<0.05);胸水CYFRA21-1浓度在恶性、结核性胸水组之间无显著差异(P=0.13),但都高于漏出液组(P<0.05);胸水IFN-γ在结核性胸水组中高于漏出液组和恶性组(P<0.05)。联合检测血清、胸水CYFRA21-1诊断结核性胸膜炎的敏感度为93.5%,特异度为74.1%;单独检测胸水IFN-γ诊断结核性胸膜炎的敏感度为87.1%,特异度为79.3%;联合检测血清、胸水CRFYA21-1以及胸水IFN-γ诊断结核性胸膜炎的敏感度为90.3%,特异度为89.6%。结论联合检测血清、胸水CYFRA21-1以及胸水IFN-γ对结核性胸膜炎的早期诊断有较高的临床参考价值。
Objective To explore the significance of combined detection of cytokeratin 19 soluble fragment （CYFRA211）and pleural gamma interferon （IFN - gamma）in pleural effusion for early diagnosis of tuberculotic pleurisy. Methods A total of 89 patients with different causes of pleural effusion were selected for this study,and serum and pleural effusion levels of CYFRA21 - 1 and hydrothorax interferon - gamma were analyzed,at the same time the best threshold figures of sensitivity and specificity had been detected by using ROC curve analysis. Results The serum concentration of CYFRA21 - 1 in malignant group was higher than that of tuberculous and transudative effusion groups （P 〈 0. 05）. There was no significant difference between the concentration of CYFRA21 - 1 in malignant pleural effusion and tuberculous pleural effusion groups （P = 0. 13）,but it was higher than that of transudate group （P 〈 0. 05）. Level of pleural IFN - gamma in tuberculotic pleural effusion group was higher than that of transudate group and malignant group （P 〈 0. 05）. The sensitivity of combined detection of serum and pleural fluid levels of CYFRA21 - 1 for diagnosis of tuberculous pleurisy was 93. 5%,and its specificity was 74. 1% . The sensitivity of separate detection of pleural IFN - gamma for diagnosis of tuberculous pleurisy was 87. 1%,and its specificity was 79. 3% . The combined detection of serum and pleural ef-fusion levels of CRFYA21 - 1 and pleural IFN - gamma CRFYA21 - 1 for diagnosis of tuberculous pleurisy was 90. 3%,and its specificity was 89. 6% . Conclusion The sensitivity of combined detection of CYFRA21 - 1 in serum and pleural effusion and IFN - gamma in pleural effusion is good for the early diagnosis of tuberculous pleurisy with higher value for clinical reference.
出处
《临床和实验医学杂志》
2018年第1期54-57,共4页
Journal of Clinical and Experimental Medicine
基金
江苏省科技厅基金项目(编号:2012-B-05-13)
