[干扰素-γ、白细胞介素-12及腺苷脱氨酶同工酶在结核性胸膜炎诊断价值中的临床研究]

[Clinical investigation of the diagnostic value of interferon-gamma, interleukin-12 and adenosine deaminase isoenzyme in tuberculous pleurisy].

作者信息

Tian Rui-xue, Gao Zhan-cheng

机构信息

Department of Respiratory Medicine, Peking University People's Hospital, Beijing 100044, China.

出版信息

Zhonghua Jie He He Hu Xi Za Zhi. 2004 Jul;27(7):435-8.

PMID:15312552

Abstract

OBJECTIVE

To investigate the diagnostic value of interferon-gamma (IFN-gamma), interleukin-12 (IL-12) and adenosine deaminase isoenzymes (ADA(2)) in tuberculous pleural effusions.

METHODS

One hundred and ninety specimens of pleural effusion were collected from 190 patients with pleural effusion in Peking University People's Hospital, Beijing Chest Hospital, and Beijing Tuberculosis and Thoracic Tumor Institute, from March 2002 to February 2003. Of them 141 pleural specimens were diagnosed as tuberculous, and 49 as malignant. IFN-gamma and IL-12 concentrations and ADA isoenzyme activity in all the specimens were determined by ELISA and enzyme kinetic analytical method respectively.

RESULTS

(1) ADA(2) activity (47.9 +/- 6.9) U/L in tuberculous effusions was significantly higher than that in malignant effusion (13.2 +/- 3.2) U/L (P < 0.01). The IFN-gamma level (112.1 +/- 45.8) ng/L in tuberculous effusion was significantly higher than that in malignant diseases (24.8 +/- 5.9) ng/L (P < 0.01). The IL-12 level (104.3 +/- 32.3) ng/L in tuberculous effusions was significantly higher than that in malignant diseases (61.8 +/- 10.8) ng/L (P < 0.05). (2) By analysis of ROC curves, the cut-off values for IFN-gamma, IL-12 and ADA(2) were defined. The sensitivity and specificity of IFN-gamma for tuberculous effusion were 84.4% and 95.9% respectively. Those of IL-12 for tuberculous effusion were 85.1% and 65.3% respectively, while those of ADA(2) were 84.4% and 91.8%.

CONCLUSIONS

IFN-gamma and IL-12 could be used as valuable parameters for the differentiation of tuberculous effusion from malignant, and IFN-gamma was more sensitive and specific for tuberculous effusion than IL-12 and ADA(2).

摘要

目的

探讨干扰素-γ（IFN-γ）、白细胞介素-12（IL-12）及腺苷脱氨酶同工酶（ADA(2)）在结核性胸腔积液中的诊断价值。

方法

2002年3月至2003年2月，从北京大学人民医院、北京胸科医院及北京市结核病胸部肿瘤研究所收集190例胸腔积液患者的190份胸腔积液标本。其中141份胸腔标本诊断为结核性，49份为恶性。所有标本中的IFN-γ和IL-12浓度及ADA同工酶活性分别采用酶联免疫吸附测定法（ELISA）和酶动力学分析法测定。

结果

（1）结核性胸腔积液中ADA(2)活性为（47.9±6.9）U/L，显著高于恶性胸腔积液中的（13.2±3.2）U/L（P<0.01）。结核性胸腔积液中IFN-γ水平为（112.1±45.8）ng/L，显著高于恶性疾病中的（24.8±5.9）ng/L（P<0.01）。结核性胸腔积液中IL-12水平为（104.3±32.3）ng/L，显著高于恶性疾病中的（61.8±10.8）ng/L（P<0.05）。（2）通过ROC曲线分析，确定了IFN-γ、IL-12和ADA(2)的临界值。IFN-γ对结核性胸腔积液的敏感性和特异性分别为84.4%和95.9%。IL-12对结核性胸腔积液的敏感性和特异性分别为85.1%和65.3%，而ADA(2)的敏感性和特异性分别为84.4%和91.8%。