CAJ | 학술논문

目的：探讨腺苷脱氨酶（ ADA）联合γ-干扰素（ IFN-γ）及脂阿拉伯甘露聚糖（ LAM）抗原对结核性胸膜炎的诊断价值。方法胸腔积液患者98例按胸腔积液性质是否为结核分为结核组（62例）与非结核组（36例）。对比分析2组患者胸腔积液与血清中ADA、IFN-γ水平及LAM的阳性率，并应用ROC曲线确定ADA联合IFN-γ及LAM抗原对结核性胸膜炎诊断的价值。结果结核组胸腔积液中ADA及IFN-γ水平明显高于非结核组[（53排．88±14．39）U/L、（496．82±183．65）pg/ml vs．（15．07±12．36）U/L、（49．74±32．18）pg/ml， P﹤0．05]；结核组与非结核组血清中ADA及IFN-γ水平的差异比较无统计学意义[（24．31±7．85）U/L、（47．88±8．35）pg/ml vs．（22．94±7．60）U/L、（45．62±7．74）pg/ml， P﹥0．05]；结核组胸腔积液及血清中LAM抗原的阳性率均明显高于非结核组（64．52％、74．19％vs．2．78％、5．56％， P﹤0．05）。胸腔积液中ADA联合IFN-γ及LAM抗原对结核性胸膜炎诊断的准确性较高，其ROC曲线下面积为0．914（95％CI 0．832～1．243）。结论胸腔积液中ADA联合IFN-γ及LAM抗原检测对结核性胸膜炎诊断的准确性较高，值得推广。
목적：탐토선감탈안매（ ADA）연합γ-간우소（ IFN-γ）급지아랍백감로취당（ LAM）항원대결핵성흉막염적진단개치。방법흉강적액환자98례안흉강적액성질시부위결핵분위결핵조（62례）여비결핵조（36례）。대비분석2조환자흉강적액여혈청중ADA、IFN-γ수평급LAM적양성솔，병응용ROC곡선학정ADA연합IFN-γ급LAM항원대결핵성흉막염진단적개치。결과결핵조흉강적액중ADA급IFN-γ수평명현고우비결핵조[（53배．88±14．39）U/L、（496．82±183．65）pg/ml vs．（15．07±12．36）U/L、（49．74±32．18）pg/ml， P﹤0．05]；결핵조여비결핵조혈청중ADA급IFN-γ수평적차이비교무통계학의의[（24．31±7．85）U/L、（47．88±8．35）pg/ml vs．（22．94±7．60）U/L、（45．62±7．74）pg/ml， P﹥0．05]；결핵조흉강적액급혈청중LAM항원적양성솔균명현고우비결핵조（64．52％、74．19％vs．2．78％、5．56％， P﹤0．05）。흉강적액중ADA연합IFN-γ급LAM항원대결핵성흉막염진단적준학성교고，기ROC곡선하면적위0．914（95％CI 0．832～1．243）。결론흉강적액중ADA연합IFN-γ급LAM항원검측대결핵성흉막염진단적준학성교고，치득추엄。
Objective To explore the adenosine deaminase ( ADA) joint γinterferon ( IFN-γ) and lipoarabinoman-nan ( LAM) antigen diagnosis of tuberculous pleurisy .Methods Pleural effusion in 98 patients according to whether the na-ture of tuberculous pleural effusion into tuberculosis group (62 cases) and non-tuberculous group (36 cases).Comparative a-nalysis of two groups of patients with pleural effusion of serum ADA , IFN-γlevels and LAM positive rate and ROC curve to determine ADA combined IFN-γand LAM antigen for diagnosis of tuberculous pleurisy value .Results Tuberculous pleural effusion ADA and IFN-γlevels were significantly higher than non-tuberculosis group [(53.88 ±14.39) U/L, (496.82 ± 183.65) pg/ml vs.(15.07 ±12.36) U/L, (49.74 ±32.18 ) pg/ml, P <0.05];tuberculous and non-tuberculous group, the serum levels of ADA and IFN-γno statistically significant difference [(24.31 ±7.85) U/L, (47.88 ±8.35) pg /ml vs. (22.94 ±7.60) U/L, (45.62 ±7.74) pg/ml, P >0.05];tuberculous pleural effusion and serum LAM antigen positive rate was significantly higher than that of non-tuberculous group (64.52% and 74.19% vs.2.78% and 5.56%, P <0.05). Pleural effusion ADA joint IFN-γand LAM antigen in the diagnosis of tuberculous pleurisy high accuracy , the area under the ROC curve was 0.914 (95%CI 0.832-1.243).Conclusion Pleural effusion ADA joint IFN-γand LAM antigen detection for the diagnosis of tuberculous pleurisy with high accuracy , is worth promoting .