摘要
目的探讨外周血抗脂阿拉伯甘露聚糖抗体(LAM-IgG)、结核感染T细胞斑点试验(T-SPOT.TB)联合胸腔积液腺苷脱氨酶(ADA)、乳酸脱氢酶(LDH)、癌胚抗原(CEA)在不明原因胸腔积液中的诊断价值。方法选择2019年9月-2021年10月本院收治并最终确诊的胸腔积液患者148例作为研究对象,检测外周血LAM-IgG、T-SPOT.TB及胸腔积液ADA、LDH、CEA水平,利用受试者工作特征曲线(ROC)分析5项指标在不同性质胸腔积液中的诊断价值。结果148例患者中有45例结核性胸腔积液、49例癌性胸腔积液、54例漏出性胸腔积液。结核性胸腔积液患者的外周血LAM-IgG、T-SPOT.TB阳性率及胸腔积液ADA水平均高于癌性胸腔积液、漏出性胸腔积液患者(P<0.05);结核性胸腔积液、癌性胸腔积液患者的胸腔积液LDH水平均高于漏出性胸腔积液患者(P<0.05);癌性胸腔积液患者的胸腔积液CEA水平均高于结核性胸腔积液、漏出性胸腔积液患者(P<0.05)。ROC曲线显示,外周血LAM-IgG、T-SPOT.TB及胸腔积液ADA、LDH、CEA诊断结核性胸腔积液的曲线下面积(AUC)分别为0.742、0.757、0.732、0.706、0.530,联合诊断的AUC为0.835;外周血LAM-IgG、T-SPOT.TB,胸腔积液ADA、LDH、CEA诊断癌性胸腔积液的AUC分别为0.528、0.569、0.529、0.749、0.765,联合诊断的AUC为0.776;外周血LAM-IgG、T-SPOT.TB,胸腔积液ADA、LDH、CEA诊断漏出性胸腔积液的AUC分别为0.526、0.522、0.513、0.533、0.546,联合诊断的AUC为0.576。结论外周血LAM-IgG、T-SPOT.TB联合胸腔积液ADA、LDH、CEA对于不同性质的胸腔积液具有不同的诊断价值,其中对结核性胸腔积液的诊断价值最高,癌性胸腔积液次之,漏出性胸腔积液最低。
Objective To investigate the clinical diagnostic value of anti lipoarabinomannanIgG(LAM-IgG)andT-cell spot of tuberculosis test(T-SPOT.TB)in peripheral blood combined with adenosine deaminase(ADA),lactate dehydrogenase(LDH)and carcinoembryonic antigen(CEA)in unidentified pleural effusion.Methods 148 patients suffered with pleural effusion those were admitted to our hospital from September 2019 to October 2021 were selected as study subjects,the levels of LAM-IgG,T-SPOT.TB in peripheral blood,ADA,LDH and CEA in pleural effusion were detected.The ROC curve was used to analyze the diagnostic value of five indicators in pleural effusion of different types.Results Among the 148 patients,45 patients had tuberculous pleural effusion,49 patients had cancerous pleural effusion,and 54 patients had leaky pleural effusion.The positive rates of LAM-IgG,T-SPOT.TB in peripheral blood and the ADA level of pleural effusion in patients with tuberculous pleural effusion were higher than those in patients with malignant pleural effusion and transudative pleural effusion(P<0.05).The LDH level of pleural effusion in patients with tuberculous pleural effusion and malignant pleural effusion was higher than that in patients with transudative pleural effusion(P<0.05).The CEA level in pleural effusion of patients with malignant pleural effusion was higher than that in patients with tuberculous pleural effusion and transudative pleural effusion(P<0.05).The ROC curve showed that the area under the curve(AUC)of LAM-IgG,T-SPOT.TB in peripheral blood,and ADA,LDH and CEA in pleural effusion in diagnosis of tuberculous pleural effusion was0.742,0.757,0.732,0.706 and 0.530,respectively,and the AUC of the joint diagnosis was 0.835.The AUC of LAM-IgG,T-SPOT.TB in peripheral blood,ADA,LDH and CEA in pleural effusion in their diagnosis of malignant pleural effusion was 0.528,0.569,0.529,0.749 and 0.765,respectively,and the AUC of their joint diagnosis was 0.776.The AUC of LAM-IgG,T-SPOT.TB in peripheral blood,ADA,LDH and CEA in pleural effusion in dia
作者
曾惠雪
李浩
汪铁柱
林立
Zeng Huixue;Li Hao;Wang Tiezhu;Lin Li(Department of respiratory and critical care medicine,Zhangzhou hospital affiliated to Fujian Medical University,Zhangzhou,Fujian,36000,China)
出处
《齐齐哈尔医学院学报》
2022年第20期1921-1924,共4页
Journal of Qiqihar Medical University
关键词
胸腔积液
联合检测
诊断能力
Pleural effusion
Combined detection
Diagnostic value
