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目的探讨胸腔积液中白细胞介素18(IL-18)的检测在结核性和恶性胸腔积液鉴别诊断中的临床价值。方法以2007年8月—2008年7月住院的95例胸腔积液患者为研究对象,其中结核性胸腔积液45例,恶性胸腔积液50例,应用酶联免疫吸附试验(ELISA)法检测胸腔积液标本中IL-18浓度。结果结核性胸腔积液组IL-18的浓度为(1200.34±530.25)pg/ml,恶性胸腔积液组IL-18的浓度为(240.40±80.49)pg/ml,结核性胸腔积液组IL-18的浓度显著高于恶性胸腔积液组(P<0.01);ROC曲线分析结果显示IL-18以360pg/ml为诊断结核性胸腔积液的临界值,其敏感度和特异度分别是89.2%和93.5%。结论胸腔积液中IL-18浓度可以作为鉴别诊断结核性胸腔积液和恶性胸腔积液的有效参考指标。
Objective To investigate the clinical value of detection of interleukin 18 (IL-18) in pleural effusion in the differential diagnosis of tuberculous and malignant pleural effusion. Methods A total of 95 patients with pleural effusion admitted to hospital from August 2007 to July 2008 were enrolled. Among them, 45 were tuberculous pleural effusion and 50 were malignant pleural effusion. ELISA was used to detect tuberculous pleural effusion IL-18 concentration in pleural effusion specimens. Results The concentration of IL-18 in tuberculous pleural effusion group was (1200.34 ± 530.25) pg / ml, that of malignant pleural effusion group was (240.40 ± 80.49) pg / ml, 18 was significantly higher than that in malignant pleural effusion group (P <0.01). The ROC curve analysis showed that the sensitivity and specificity of IL-18 at the diagnostic value of 360 pg / ml for tuberculous pleural effusion were 89.2% And 93.5%. Conclusion The concentration of IL-18 in pleural effusion can be used as a effective reference for the differential diagnosis of tuberculous pleural effusion and malignant pleural effusion.