三种检测方法对结核、恶性胸腔积液的鉴别价值

发布时间：2018-03-02 13:19

本文选题：γ-干扰素释放试验　切入点：白介素-　出处：《基因组学与应用生物学》2017年04期 　论文类型：期刊论文

【摘要】：为了研究内科胸腔镜术、外周血及胸腔积液T-SPOT.TB、血清和胸腔积液IL-6(interleukin-6,IL-6)水平检测对于鉴别结核性和恶性胸腔积液的价值。我们纳入经内科胸腔镜确诊的结核性胸腔积液(tuberculous pleural effusion,TPE)患者49例、恶性胸腔积液(malignant pleural effusion,MPE)患者37例,入选患者均完善外周血及胸腔积液T-SPOT.TB和IL-6水平检测,对检测结果进行统计分析。(1)内科胸腔镜镜下显示:TPE患者主要表现为大小不等的粟粒样结节,常伴胸膜粘连、充血、水肿;MPE患者主要表现为大小不等的结节样改变,常伴胸膜凹凸不平、触之易出血。(2)胸腔积液T-SPOT.TB与IL-6水平检测的诊断效能高于外周血T-SPOT.TB和血清IL-6检测。其曲线下面积分别为0.910、0.875,胸腔积液T-SPOT的SFC数的最佳临界值为217/2.5×105/L,胸腔积液IL-6检测的最佳临界值为226 pg/m L。(3)胸腔积液T-SPOT.TB和IL-6检测的灵敏度、特异度、准确率分别为0.857、0.811、0.837,0.857、0.784、0.826,高于外周血T-SPOT.TB和血清IL-6检测。由结果可知,(1)内科胸腔镜具有直观、切口小、并发症少等优点,应用价值高。(2)胸腔积液T-SPOT.TB和IL-6水平测定可以用于辅助鉴别结核性和恶性胸腔积液,外周血T-SPOT.TB和IL-6水平对鉴别结核性、恶性胸腔积液的意义相对较小。
[Abstract]:In order to study thoracoscopic surgery in internal medicine, The value of serum and pleural effusion interleukin-6 interleukin-6 (IL-6) in differentiating tuberculous pleural effusion from malignant pleural effusion was studied in 49 patients with tuberculous pleural effusion confirmed by thoracoscopy. Thirty-seven patients with malignant pleural effusion (MPEGE) were enrolled in this study. T-SPOT.TB and IL-6 levels in peripheral blood and pleural effusion were all improved. The results were statistically analyzed. MPE patients with pleural adhesion, hyperemia and edema were mainly presented with nodule changes of varying sizes, often accompanied by uneven pleura. The diagnostic efficacy of T-SPOT.TB and IL-6 levels in pleural effusion was higher than that in peripheral blood T-SPOT.TB and serum IL-6. The area under the curve was 0.9100.85, and the best critical value of T-SPOT SFC number in pleural effusion was 217r2.5 脳 105L, and that of IL-6 in pleural effusion was the most significant. Sensitivity of T-SPOT.TB and IL-6 in pleural effusion, The specificity and accuracy were 0.857 ~ 0.811 ~ 0.837 ~ 0.857 ~ (0.784) ~ 0.784 ~ 0.826, respectively, which were higher than that of T-SPOT.TB in peripheral blood and IL-6 in serum. The results showed that thoracoscopy had the advantages of intuitionistic, small incision, less complications, and so on. The levels of T-SPOT.TB and IL-6 in pleural effusion can be used to differentiate tuberculous from malignant pleural effusion. The level of T-SPOT.TB and IL-6 in peripheral blood is of little significance in differentiating tuberculous from malignant pleural effusion.
【作者单位】：河北大学;河北大学附属医院呼吸内科;
【分类号】：R521.7;R730.43

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