中国综合临床
中國綜閤臨床
중국종합림상
CLINICAL MEDICINE OF CHINA
2011年
2期
161-163
,共3页
结核性胸膜炎%诊断%似然比
結覈性胸膜炎%診斷%似然比
결핵성흉막염%진단%사연비
Pleural tuberculosis%Diagnosis%Likelihood ratios
目的 探讨结核性胸膜炎(PT)的临床诊断依据.方法 回顾性分析2007年12月至2009年12月我院收治的180例以胸腔积液住院患者,其中90例确认为PT,90例确认为非PT,计算胸液腺苷脱氨酶(ADA)、γ-干扰素(IFN-γ)、可溶性白细胞介素-2受体(sIL-2R)、血与胸液结核抗体、年龄、发热6项指标诊断PT的似然比(LR)、灵敏度、特异度、阳性预测值及阴性预测值.结果 6项指标中,胸液ADA最佳临界值的LR+最高,其次是血与胸液结核抗体、IFN-γ、年龄、sIL-2R、发热.若同时达到此6项指标的最佳诊断界值,患PT的可能性为99.9%以上,若6项指标均未达到最佳诊断界值,则患PT的可能性下降为1%以下.6项指标中任意4项满足条件时,患PT的可能性也在97%以上.结论 联合此6项指标对PT进行临床诊断分析,有利于早期诊断,指导治疗,避免并发症的发生.
目的 探討結覈性胸膜炎(PT)的臨床診斷依據.方法 迴顧性分析2007年12月至2009年12月我院收治的180例以胸腔積液住院患者,其中90例確認為PT,90例確認為非PT,計算胸液腺苷脫氨酶(ADA)、γ-榦擾素(IFN-γ)、可溶性白細胞介素-2受體(sIL-2R)、血與胸液結覈抗體、年齡、髮熱6項指標診斷PT的似然比(LR)、靈敏度、特異度、暘性預測值及陰性預測值.結果 6項指標中,胸液ADA最佳臨界值的LR+最高,其次是血與胸液結覈抗體、IFN-γ、年齡、sIL-2R、髮熱.若同時達到此6項指標的最佳診斷界值,患PT的可能性為99.9%以上,若6項指標均未達到最佳診斷界值,則患PT的可能性下降為1%以下.6項指標中任意4項滿足條件時,患PT的可能性也在97%以上.結論 聯閤此6項指標對PT進行臨床診斷分析,有利于早期診斷,指導治療,避免併髮癥的髮生.
목적 탐토결핵성흉막염(PT)적림상진단의거.방법 회고성분석2007년12월지2009년12월아원수치적180례이흉강적액주원환자,기중90례학인위PT,90례학인위비PT,계산흉액선감탈안매(ADA)、γ-간우소(IFN-γ)、가용성백세포개소-2수체(sIL-2R)、혈여흉액결핵항체、년령、발열6항지표진단PT적사연비(LR)、령민도、특이도、양성예측치급음성예측치.결과 6항지표중,흉액ADA최가림계치적LR+최고,기차시혈여흉액결핵항체、IFN-γ、년령、sIL-2R、발열.약동시체도차6항지표적최가진단계치,환PT적가능성위99.9%이상,약6항지표균미체도최가진단계치,칙환PT적가능성하강위1%이하.6항지표중임의4항만족조건시,환PT적가능성야재97%이상.결론 연합차6항지표대PT진행림상진단분석,유리우조기진단,지도치료,피면병발증적발생.
Objective To investigate the clinical diagnostic evidences of pleural tuberculosis (PT).Methods One hundred and eighty patients with pleural effussion, whom were admited into our hospital from December 2007 to December 2009 ,were enrolled into this study. The clinical data of patients confirmed with PT ( n = 90) or Non-PT ( n = 90) were analyzed retrospectively. The likelihood ratios( LR), sensitivity, specificity,positive predictive value,and nagative predictive value of six indices including pleural ADA, IFN-γ, sIL-2R ,TB-antibody in blood and pleural effusion, age and fever status were calculated. Results The variable with the hightest LR+ was ADA optimal threshold, followed by TB-antibody, IFN-γ, age, sIL-2R, fever status, If all six variables reached the optimal threshold,the probabilities of PT exceeded 99.9%. However,if all variables didn't reached the optimal threshold, the probabilities of PT were less than 1%. Among all the six variables, any four or over four variables reached the optimal threshold, the probabilities of PT exceeded 97%. Conclusion The combination use of these six variables can aid the clinical analysis, early detection, and therapy instruction,complication prevention of PT.
