摘要
目的应用液态芯片技术联合检测胸腔积液中干扰素（IFN）-y IFN-y诱导蛋白（IP）-10水平，探讨其在临床快速诊断及鉴别诊断结核性胸腔积液中的应用价值。方法选取渗透性胸腔积液患者，其中结核性胸腔积液组52例；恶性胸腔积液组38例。利用结核感染T细胞斑点试验（T-SPOT．TB）测定其对结核杆菌反应的效应T细胞数量，即斑点形成细胞数（SFCs），同时利用液态芯片技术测定其IFN-y和IP-10水平，通过Logistic逐步回归法评估IFN-y和IP-10联合诊断时的价值，并比较两种诊断方法的价值。结果T-SPOT．TB法诊断结核性胸腔积液的灵敏度为90．38％，特异度为84．21％，ROC曲线下面积（AUC）及95％CI为0．938（0．867～0．978）；IFN-y、IP－10联合诊断结核性胸腔积液时的灵敏度为98．08％，特异度为97．37％，AUC及95％CI为0．995（0．951～1．000）。2种诊断方法灵敏度和特异度的差异不明显；2种方法诊断一致性良好（Kappa=0．703）；方法间AUC比较差异有统计学意义（z=1．996，P〈0．05），检测IFN-y IP－10水平联合诊断时AUC较大（AUC=0．995）。结论利用液态芯片技术同时检测IFN-y、IP-10水平联合诊断结核性胸腔积液满足了临床快速、准确诊断及鉴别诊断结核性胸腔积液的需要。
Objective To explore the diagnostic value of combined detection of the liquid array technology, interfer- on （IFN）-y and IFN-y-inducible protein （IP）- 10 in the rapid, accurate diagnosis and differential diagnosis of tuberculous pleural effusions. Methods Patients with transudative pleural effusions were divided into tuberculous pleural effusion group （n=52） and malignant pleural effusion group （n=38）. The method of T-SPOT.TB was used to detect the number of effec- tor T cells sensitized to Mycobacterium tuberculosis and spot forming cells （SFCs）. The liquid array technology was used to detect the level of IFN-y and IP-10. Logistic regression was used to analyze and compare the diagnostic value of the two- method combination. Results The diagnostic sensitivity, specificity and the area under the ROC curve （AUC） of T-SPOT. TB were 90.38%, 84.21%, and 0.938 （95%CI： 0.867-0.978）, respectively. The diagnostic sensitivity, specificity and AUC of combined detection of IFN-yand IP-10 were 98.08%, 97.37%, and 0.995 （95%CI： 0.951-1.000）, respectively. There was no significant difference in the diagnostic sensitivity and specificity between the two methods, and the diagnostic agreement for the two diagnostic methods was fine （Kappa=0.703）. The difference of AUC between the methods was significantly differ- ent （Z=1.996, P 〈0.05）. The method of combined detection of IFN-yand IP-10 showed the larger AUC （AUC= 0.995）. Con- clusion The combined diagnosis meets the clinical needs of rapid, accurate diagnosis and differential diagnosis for tuber- culous pleural effusion by simultaneously assaying the level of IFN-yand IP-10 using the liquid array technology.
出处
《天津医药》
CAS
北大核心
2014年第9期943-945,共3页
Tianjin Medical Journal
基金
天津市卫生局科技基金项目(2013KZ042)
