傅京力+李远+谭英征+龙云铸+赵斌+李丹

[摘要] 目的 探讨结核性胸膜炎患者血浆和胸腔积液中干扰素-γ（IFN-γ）、腺苷脱氨酶（ADA）在结核性胸膜炎诊断中的临床价值。 方法 选择2010年6月～2013年5月株洲市中心医院治疗的结核性胸膜炎54例为结核组，选择同期健康体检者48例为健康对照组。结核组检测血浆和胸腔积液中IFN-γ和ADA浓度，并与健康对照组血浆中IFN-γ和ADA进行对比分析。 结果 结核组血浆中IFN-γ浓度[（36.5±13.6）ng/L]显著高于对照组[（12.8±2.7）ng/L]，差异有高度统计学意义（P < 0.01）；结核组胸腔积液中IFN-γ[（125.6±21.3）ng/L]和ADA[（52.5±8.9）U/L]水平明显高于血浆中IFN-γ[（36.5±13.6）ng/L]、ADA[（19.5±4.3）U/L]水平，差异均有高度统计学意义（P < 0.01）。 结论 IFN-γ、ADA可作为诊断结核性胸膜炎的可靠指标，值得临床推广。

[关键词] 结核性胸膜炎；干扰素；腺苷脱氨酶

[中图分类号] R561.3[文献标识码] A[文章编号] 1673-7210（2014）04（c）-0025-03

Value of IFN-γ and ADA level in diagnosis of tuberculous pleurisy

FU Jingli1 LI Yuan2 TAN Yingzheng1 LONG Yunzhu1 ZHAO Bin1 LI Dan1

1.Department of Infections Diseases, Central Hospital of Zhuzhou City, Hu'nan Province, Zhuzhou 412007, China; 2.Hu'nan Traditional Chinese Medicine College, Hu'nan Province, Zhuzhou 412012, China

[Abstract] Objective To explore the clinical value of IFN-γ and ADA within plasma and pleural effusion of the patient in diagnosing tuberculous pleurisy. Methods 54 cases of tuberculous pleurisy from June 2010 to May 2013 in Central Hospital of Zhuzhou City were selected as tuberculosis group, 48 healthy cases in the same term were chosen as healthy control group. The concentrations of IFN-γ and ADA were tested within plasma and pleural effusion of patients in tuberculosis group, IFN-γ and ADA were tested within plasma in healthy control group and compared with tuberculosis group. Results The concentrations of IFN-γ in plasma in tuberculosis group [(36.5±13.6) ng/L] were significantly higher than that in healthy control group [(12.8±2.7) ng/L], the difference was statistically significant (P < 0.01). In tuberculosis group, the level of IFN-γ [(125.6±21.3) ng/L] and ADA [(52.5±8.9) U/L] in pleural effusion were much higher than those in plasma [(36.5±13.60) ng/L, (19.5±4.3) U/L respectively], the differences were statistically significant (P < 0.01). Conclusion IFN-γ and ADA are the reliable index of diagnosing tuberculous pleurisy, which are worth for clinical use.

[Key words] Tuberculous pleurisy; Interferon; Adenosine deaminase

结核性胸膜炎是临床上引起胸腔积液的常见疾病之一，在我国胸腔积液住院患者中占到49.5%～54.5%[1]。该病在临床上表现多样，缺乏特异性，仅根据临床表现、实验检查资料和影像学检查结果很难准确判断胸腔积液引起的原因[2]。诊断通常以胸膜活检发现肉芽肿或活检组织、胸水找到抗酸杆菌为标准。在临床工作中，患者不易接受胸膜活检，而通过胸水检测结核杆菌阳性率低，重复上述检查可能会提高阳性率，但会增加患者并发症风险及经济负担。及时、准确诊断结核性胸膜炎是患者获得良好治疗的前提，因此寻找一些方便有效又可信的指标迫在眉睫。本研究通过检测结核性胸膜炎患者血浆和胸腔积液中干扰素……