摘要
目的：探讨γ干扰素（Interferon-γ,IFN-γ）、白细胞介素18（Interleukin-18,IL-18）、C反应蛋白（C-reactive protein,CRP）以及腺苷脱氨酶（Adenosine deaminase,ADA）在老年结核性以及恶性胸腔积液患者血清及胸腔积液中的表达及意义.方法选取40例老年结核性胸腔积液患者及40例老年恶性胸腔积液患者为研究对象,另选取30例老年健康人群为对照组,检测其血清及胸腔积液中IFN-γ、IL-18、CRP水平以及ADA活性,绘制受试者工作特征曲线（ROC）,分析IFN-γ、IL-18、CRP以及ADA检测对老年结核性胸腔积液诊断的特异性以及敏感性.结果：三组血清IFN-γ及IL-18水平差异无统计学意义（P＞0.05）;而结核组血清CRP水平及ADA活性均显著高于恶性组和对照组,差异具有统计学意义（P＜0.05）.结核组胸腔积液中IFN-γ、IL-18、CRP水平以及ADA活性均明显高于恶性胸腔积液组,差异均具有统计学意义（P＜0.05）.ROC曲线分析得出,IFN-γ检测的曲线下面积最大为0.920（95％ CI为0.823-1.000）,最佳临界值为113.2 ng/L,其预测结核性胸腔积液的敏感性为90.0％,特异性为85.0％;IL-18、CRP以及ADA的曲线下面积分别为0.838、0.809和0.874,最佳临界值分别为844.3 ng/L、28.3 mg/L和38.4 U/L.结论：胸腔积液IFN-γ、IL-18、CRP以及ADA水平检测对诊断老年结核性胸腔积液均具有较好的效果,对胸液中四种标志物进行检测有助于鉴别老年结核性和恶性胸腔积液以及指导临床治疗.
OBJECTIVE ： To investigate the expression and significance of Interferon - γ （ IFN - γ ） , Intedeukin - 18 （ IL - 18 ）, C - reactive protein （CRP） and Adenosine deaminase （ ADA ） on tuberculous and malignant pleural effusion in elderly pa- tients. METHODS： 40 elderly patients with tuberculous pleural effusion and 40 elderly patients with malignant plenral effusion were enrolled in this study, and 30 elderly healthy people were collected as control group. The levels of IFN - γ, IL - 18, CRP and ADA activity in serum and pleural effusion were measured. The receiver operator characteristic curves （ROC） were drawn out to analyse thediagnostic sensitivity and specificity of IFN- γ, IL- 18, CRP and ADA in tuberculous pleural effusion. RESULTS： There were no significant differences in levels of IFN -γand IL -18 in serum among three groups （P 〉 0. 05 ）. The levels of CRP and the ADA ac- tivity in serum of the patients with tuberculous pleural effusion were significantly higher than those of the patients with malignant pleural effusion and healthy people （P 〈0. 05）. The levels of IFN-γ, IL- 18, and CRP and ADA activity in pleural effusion of the pa- tients with tuberculous pleural effusion were significantly higher than those of the patients with malignant pleural effusion and healthy people （ P 〈 0. 05 ）. According to the ROC curve, the area of IFN - γunder the ROC curve was O. 920 （95% CI was 0. 807 - 0. 987） which was bigger than the ones of IL - 18, CRP and ADA. The best critical value of IFN - γ was 113.2ng/L. The sensitivity and specificity of IFN - γ were 90. 0% and 85.0% respectivly. The areas under ROC curve of IL - 18, CRP and ADA were 0. 838, 0. 809 and 0. 874 respectivly. The best critical values of IL - 18, CRP and ADA were 844. 3ng/L, 28.3mg/L and 38.4 U/L. CON- CLUSION： The levels of IFN -γ, IL- 18 and CRP and ADA activity in pleural effusion have high effect in the diagnosis of tubercu- lous pleural effusion. Monitoring the levels of IFN -γ, IL - 18 and CRP and ADA activity in pleural effusion may be helpful to diag- nosising tuberculous pleural effusion.
出处
《国际老年医学杂志》
2016年第3期124-127,共4页
International Journal of Geriatrics
基金
河北省卫生厅医学科学研究课题（20130440）河北省卫生厅医学科学研究重点研究计划（20090264）
关键词
结核性胸腔积液
恶性胸腔积液
Γ干扰素
白细胞介素18
C反应蛋白
腺苷脱氨酶
Tuberculous pleural effusion
Malignant pleural effusion
Interferon - γ
Interleukin - 18
C - reactive protein
Adenosine deaminase
