胸腔积液中IL-27和IFN-γ检测对结核性胸膜炎的诊断价值

doi:10.13481/j.1671-587x.20190224

吉林大学学报(医学版) ›› 2019, Vol. 45 ›› Issue (02): 353-358.doi: 10.13481/j.1671-587x.20190224

• 临床研究 • 上一篇

胸腔积液中IL-27和IFN-γ检测对结核性胸膜炎的诊断价值

李芳¹, 张坚², 郝雪琦³, 申思³, 季凯³, 孙玉宁⁴

1. 宁夏医科大学总医院呼吸与危重症医学科, 宁夏银川 750004;
2. 宁夏人民医院呼吸内科, 宁夏银川 750000;
3. 宁夏医科大学临床医学院, 宁夏银川 750004;
4. 宁夏医科大学基础医学院生化与分子生物学教研室, 宁夏银川 750004

收稿日期:2018-04-26 发布日期:2019-03-29
通讯作者: 孙玉宁,教授,博士研究生导师(Tel:0951-6980116,E-mail:sunraining2008@hotmail.com) E-mail:sunraining2008@hotmail.com
作者简介:李芳(1972-),女,宁夏回族自治区银川市人,主任医师,医学硕士,主要从事慢性缺氧肺动脉高压发病机制和呼吸道感染等方面的研究。
基金资助:
国家自然科学基金资助课题（81560340）；宁夏回族自治区科技厅自然科学基金资助课题（NZ17158，NZ15061）

Values of IL-27 and IFN-γ in pleural effusion in diagnosis of tuberculous pleuritis

LI Fang¹, ZHANG Jian², HAO Xueqi³, SHEN Si³, JI Kai³, SUN Yuning⁴

1. Department of Respiratory and Critical Care Medicine, General Hospital, Ningxia Medical University, Yinchuan 750004, China;
2. Department of Respiratory Medicine, Ningxia People's Hospital, Yinchuan 750000, China;
3. School of Clinical Medicine, Ningxia Medical University, Yinchuan 750004, China;
4. Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Ningxia Medical University, Yinchuan 750004, China

Received:2018-04-26 Published:2019-03-29

摘要/Abstract

摘要： 目的：检测胸腔积液中白细胞介素27（IL-27）和γ-干扰素（IFN-γ）水平，探讨IL-27和IFN-γ对结核性胸膜炎的诊断价值。方法：选择以胸腔积液就诊的患者88例，按诊断结果分为结核性胸腔积液（TPE）组44例、恶性胸腔积液组20例、类肺炎性胸腔积液组12例和漏出性胸腔积液组12例。检测各组患者胸腔积液中IL-27、IFN-γ和腺苷脱氨酶（ADA）水平，绘制受试者工作特征（ROC）曲线，根据敏感度、特异度和准确度等指标评价其对结核性胸膜炎的诊断价值。结果：TPE组患者胸腔积液中IL-27和IFN-γ水平明显高于其他3组（P<0.05）。胸腔积液中IL-27、IFN-γ和ADA诊断结核性胸膜炎的ROC曲线下面积（AUC）分别为0.96、0.79和0.92，敏感度分别为100.0%、61.4%和78.6%，特异度分别为94.4%、89.5%和92.1%；IL-27、IFN-γ和ADA三者联合检测时，特异度（97.4%）高于单独检测。结论：胸腔积液中IL-27、IFN-γ和ADA检测可作为鉴别结核性胸膜炎的有效方法。单独检测时胸腔积液IL-27对结核性胸膜炎诊断价值高于IFN-γ和ADA，联合检验对诊断结核性胸膜炎具有重要价值。

关键词: 结核性胸膜炎, 白细胞介素27, γ-干扰素, 腺苷脱氨酶

Abstract: Objective: To detect the levels of interleukin-27 (IL-27) and interferon-γ(IFN-γ) in pleural effusion,and to explore the values of IL-27 and IFN-γ in the diagnosis of tuberculous pleuritis.Methods: A total of 88 patients with pleural effusion were selected and divided into tuberculous pleural effusion (TPE) group(n=44),malignant pleural effusion group(n=20),parapneumonia pleural effusion group(n=12), and transudative pleural effusion group(n=12).The levels of IL-27, IFN-γ and adenosine deaminase(ADA) in pleural effusion of the patients in various groups were detected; the receiver operating characteristic (ROC) curve was drawn to evaluate their diagnostic values for tuberculous pleuritis.Results: The levels of IL-27 and IFN-γ in pleural effusion of the patients in TPE group were significantly higher than the other three groups(P<0.05).The areas under ROC curve (AUC) of IL-27, IFN-γ and ADA in pleural effusion in diagnosis of tuberculous pleuritis were 0.96, 0.79 and 0.92, respectively;the specificities were 94.4%, 89.5% and 92.1%, respectively;the sensitivities were 100%, 61.4% and 78.6%,respectively.The specificity (97.4%) of combined detection of IL-27, IFN-γ and ADA was higher than those of single detection.Conclusion: The levels of IL-27, IFN-γ and ADA in pleural effusion can be used as an effective method to the differential diagnosis of tuberculous pleuritis.Detection of IL-27 in pleural effusion has a higher diagnostic value for tuberculous pleuritis than IFN-γ and ADA.Combined detection of IL-27, IFN-γ and ADA has the important value in the diagnosis of tuberculous pleuritis.

Key words: tuberculous pleuritis, interleukin-27, interferon-γ, adenosine deaminase

中图分类号:

R521.7

李芳, 张坚, 郝雪琦, 申思, 季凯, 孙玉宁. 胸腔积液中IL-27和IFN-γ检测对结核性胸膜炎的诊断价值[J]. 吉林大学学报(医学版), 2019, 45(02): 353-358.

LI Fang, ZHANG Jian, HAO Xueqi, SHEN Si, JI Kai, SUN Yuning. Values of IL-27 and IFN-γ in pleural effusion in diagnosis of tuberculous pleuritis[J]. Journal of Jilin University(Medicine Edition), 2019, 45(02): 353-358.

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胸腔积液中IL-27和IFN-γ检测对结核性胸膜炎的诊断价值

Values of IL-27 and IFN-γ in pleural effusion in diagnosis of tuberculous pleuritis

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