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[目的]探讨白细胞介素18(IL-18)和γ-干扰素(IFN-γ)联合检测鉴别结核性和恶性胸积液的价值及临床意义。[方法]采用酶联免疫吸附法,检测34例结核性胸腔积液和38例恶性胸腔积液患者胸水及血清标本中的IL-18和IFN-γ浓度,正常对照组18例患者仅检测血清中IL-18和IFN-γ浓度。[结果]对照组、结核性胸腔积液组、恶性胸腔积液组血清IL-18的浓度分别为152±58ng/L、190±51ng/L和159±53ng/L,IFN-γ的浓度分别为42±26ng/L、70±72ng/L和53±43ng/L,三组比较均无显著性差异(P>0.05)。结核性胸腔积液组、恶性胸腔积液组胸水IL-18的浓度分别为1111±190ng/L、316±162ng/L,IFN-γ的浓度分别为1008±309ng/L、31±10ng/L,两组比较均有显著性差异(P<0.01)。[结论]胸水中IL-18和IFN-γ联合检测对于鉴别诊断结核性和恶性胸腔积液有较大的临床价值。
[Objective] To investigate the value and clinical significance of combined detection of interleukin 18 (IL-18) and interferon-γ (IFN-γ) in the differential diagnosis of tuberculous and malignant pleural effusion. [Methods] The concentrations of IL-18 and IFN-γ in pleural effusion and serum samples from 34 patients with tuberculous pleural effusion and 38 patients with malignant pleural effusion were detected by enzyme-linked immunosorbent assay (ELISA), 18 patients in the normal control group were only detected serum In IL-18 and IFN-γ concentrations. [Results] The serum concentrations of IL-18 in control group, tuberculous pleural effusion group and malignant pleural effusion group were 152 ± 58ng / L, 190 ± 51ng / L and 159 ± 53ng / L, respectively. The concentrations of IFN- 42 ± 26ng / L, 70 ± 72ng / L and 53 ± 43ng / L, there was no significant difference between the three groups (P> 0.05). The concentrations of IL-18 in tuberculous pleural effusion group and malignant pleural effusion group were 1111 ± 190ng / L and 316 ± 162ng / L respectively, and the concentrations of IFN-γ were 1008 ± 309ng / L and 31 ± 10ng / L respectively There was significant difference between the two groups (P <0.01). [Conclusion] The combined detection of IL-18 and IFN-γ in pleural fluid has great clinical value for the differential diagnosis of tuberculous and malignant pleural effusion.