IL-10和IL-12检测在结核性和恶性胸腔积液鉴别诊断中的应用

发布时间：2018-01-19 06:28

本文关键词： 结核性胸腔积液恶性胸腔积液白细胞介素白细胞介素　出处：《吉林大学学报(医学版)》2017年04期 　论文类型：期刊论文

【摘要】：目的:通过检测结核性和恶性胸腔积液患者血清和胸腔积液中白细胞介素10(IL-10)和白细胞介素12(IL-12)的水平,探讨二者对于鉴别结核性和恶性胸腔积液的价值。方法:选取住院未经治疗的渗出性胸腔积液患者48例,根据病因分为结核性胸腔积液组25例和恶性胸腔积液组23例。采用流式微球阵列法(CBA)检测2组患者血清和胸腔积液中IL-10和IL-12的水平,比较2组患者IL-10、IL-12水平和IL-12/IL-10比值的差异;通过受试者工作特征(ROC)曲线分析上述指标与胸水脱落细胞和腺苷脱氢酶(ADA)在鉴别结核性和恶性胸腔积液中的作用。结果:结核性胸腔积液组和恶性胸腔积液组患者血清中IL-10、IL-12水平和IL-12/IL-10比值比较差异无统计学意义(P0.05),恶性胸腔积液组患者胸腔积液中IL-12水平和IL-12/IL-10比值明显低于结核性胸腔积液组(P0.01)。利用胸腔积液IL-12水平鉴别结核性和恶性胸腔积液的ROC曲线下面积为0.984,明显高于IL-12/IL-10比值(0.744)、脱落细胞(0.804)和ADA(0.911)。结论:胸腔积液中IL-12水平检测有助于结核性和恶性胸腔积液的鉴别诊断,且标本容易获取,值得临床上推广应用。
[Abstract]:Objective: to detect the levels of interleukin-10 (IL-10) and interleukin-12 (IL-12) in serum and pleural effusion of patients with tuberculous and malignant pleural effusion. To explore the value of the two methods in differentiating tuberculous and malignant pleural effusion. Methods: 48 cases of untreated exudative pleural effusion were selected. According to the etiology, 25 cases of tuberculous pleural effusion and 23 cases of malignant pleural effusion were divided into two groups. The levels of IL-10 and IL-12 in serum and pleural effusion were measured. The levels of IL-10 and IL-12 and the ratio of IL-12/IL-10 were compared between the two groups. The relationship between the above indexes and the exfoliated cells in pleural effusion and adenosine dehydrogenase (Ada) was analyzed by the operating characteristics of the subjects. Results: serum IL-10 in patients with tuberculous pleural effusion and malignant pleural effusion. There was no significant difference between IL-12 level and IL-12/IL-10 ratio (P 0.05). The level of IL-12 and the ratio of IL-12/IL-10 in malignant pleural effusion group were significantly lower than those in tuberculous pleural effusion group (P 0.01). The area under the ROC curve for differential diagnosis of tuberculous and malignant pleural effusion by IL-12 level in pleural effusion was 0.984. The ratio of IL-12/IL-10 was significantly higher than that of IL-12/IL-10 (0.744). Conclusion: the detection of IL-12 level in pleural effusion is helpful to the differential diagnosis of tuberculous and malignant pleural effusion, and the specimen is easy to obtain. It is worth popularizing in clinic.
【作者单位】：吉林大学第一医院呼吸内科;吉林大学第一医院急诊内科;空军航空大学门诊部;
【基金】：吉林省科技厅科技发展计划项目资助课题(20110489);吉林省科技厅医药产业发展专项资金项目资助课题(20130727040YY) 吉林大学白求恩培育项目资助课题(2015328)
【分类号】：R521.7;R730.43
【正文快照】： 结核和肿瘤是渗出性胸腔积液最常见的病因,巨噬细胞参与了二者的发病过程。目前研究[1-3]显示:经典活化的M1型巨噬细胞参与了结核胸膜炎的早期发病过程,而替代活化的M2型巨噬细胞参与了恶性胸腔积液的发病,M1型巨噬细胞以分泌白细胞介素12(interleukin-12,IL-12)为主、M2型巨

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