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目的探讨联合检测胸液C-反应蛋白(CRP)和腺苷脱氨酶(ADA)在诊断类肺炎性胸腔积液、结核性胸腔积液和癌性胸腔积液的价值。方法回顾性分析诊断明确的18例类肺炎性胸腔积液、28例结核性胸腔积液和42例癌性胸腔积液患者的临床资料,比较三者胸液中CRP及ADA含量的差别。结果①胸液CRP水平:类肺炎性胸腔积液(12.38±8.01)mg/dL,显著高于结核性胸液(3.64±1.85)mg/dL和癌性胸液患者(1.43±1.18)mg/dL(P<0.01),结核性胸腔积液患者胸液CRP水平显著高于癌性胸腔积液患者(P<0.05)。②胸液ADA水平:类肺炎性胸腔积液患者(47.73±19.11)U/L,与结核性胸腔积液(84.02±55.11)U/L和癌性胸腔积液患者(26.14±12.09)U/L存在显著统计学差异(P=0.00031)。③若两项指标联合检测(即胸液CRP>1mg/dL且ADA>40U/L),则诊断结核性胸腔积液的敏感性为92.7%,特异性为97.3%,较单独检测明显提高准确性。结论胸液CRP和ADA在类肺炎性、结核性和癌性胸腔积液中分别存在明显著统计学差异,可以单独作为检测指标鉴别胸腔积液性质,联合检测胸液CRP、ADA对胸腔积液性质的鉴别诊断意义更大,准确性明显提高,值得在临床上进一步推广。
Objective To investigate the value of combined detection of pleural fluid C-reactive protein (CRP) and adenosine deaminase (ADA) in the diagnosis of pneumococcal pleural effusion, tuberculous pleural effusion and cancerous pleural effusion. Methods The clinical data of 18 patients with pleural effusion, 28 patients with tuberculous pleural effusion and 42 patients with cancerous pleural effusion were retrospectively analyzed. The difference of CRP and ADA in pleural effusion between the three groups was compared. Results ① The level of CRP in pleural effusion was (12.38 ± 8.01) mg / dL, which was significantly higher than that in tuberculous pleural effusion (3.64 ± 1.85) mg / dL and cancerous pleural effusion (1.43 ± 1.18) mg / dL (P <0.01). The CRP level in pleural effusion in patients with tuberculous pleural effusion was significantly higher than that in cancerous pleural effusion (P <0.05). (2) The level of ADA in pleural effusion was 47.73 ± 19.11 U / L in patients with pulmonary pleural effusion and 26.14 ± 12.09 U / L in tuberculous pleural effusion (84.02 ± 55.11) U / L there is a significant statistical difference (P = 0.00031). ③ If the two indicators combined test (ie, pleural fluid CRP> 1mg / dL and ADA> 40U / L), the diagnosis of tuberculous pleural effusion was 92.7% sensitivity and specificity of 97.3%, compared with the single test was significantly improved accuracy Sex. Conclusion Pleural effusion CRP and ADA in lung-like, tuberculous and cancerous pleural effusion were significantly different, respectively, can be used as a separate test to identify the nature of pleural effusion, combined detection of pleural fluid CRP, ADA pleural effusion The significance of the differential diagnosis of the nature of the larger, significantly improved accuracy, it is worth further promotion in the clinic.