结核与肺部疾病杂志2025，Vol.6Issue(5)：525-531,7.DOI:10.19983/j.issn.2096-8493.20250068
胸腔积液腺苷脱氨酶、全血γ-干扰素和白细胞介素2检测对结核性胸膜炎的诊断价值
The diagnostic value of adenosine deaminase in pleural fluid,whole blood γ-interferon,and interleukin-2 for tuberculous pleurisy
摘要
Abstract
Objective:To evaluate the diagnostic performance of pleural fluid adenosine deaminase(ADA),whole blood γ-interferon(IFN-γ),and interleukin-2(IL-2)in tuberculous pleurisy(TBP).Methods:A retrospective study was conducted,clinical data from 353 patients with pleural effusion admitted to Lanzhou Chest Hospital between 2023 and 2024 were collected.The data included gender,age,ADA levels,serum total protein(TP)and lactate dehydrogenase(LDH)levels,as well as whole blood IFN-γ and IL-2 levels.Based on the final clinical diagnosis,patients were divided into a TBP group(n=193)and a non-TBP group(n=160).The levels of ADA,IFN-γ,and IL-2 levels were compared.The diagnostic efficacy of each indicator individually and in combination were evaluated using the area under the receiver operating characteristic curve(AUC),sensitivity,specificity,and Kappa values.Results:The levels of ADA,IFN-γ,and IL-2(35.00(19.00,46.90)U/L,13.50(1.42,65.26)pg/ml,and 6.32(0.67,43.36)pg/ml,respectively)in the TBP group were significantly higher than those in the control group(9.00(5.00,20.00)U/L,2.95(0.00,15.06)pg/ml,and 2.38(0.00,13.52)pg/ml,respectively)(Z=17.603,P＜0.001;Z=14.816,P＜0.001;Z=65.693,P＜0.001).For individual indicators,the sensitivities of ADA,IFN-γ,and IL-2 were 82.38％(159/193),55.96％(108/193),and 59.07％(114/193);the specificities were 67.50％(108/160),71.88％(115/160),and 62.50％(100/160),respectively;the positive predictive values were 75.36％(159/211),70.59％(108/153),and 65.52％(114/174),the AUC values were 0.800,0.649,and 0.605,and Kappa values were 0.459,0.257,and 0.177,respectively.For combined detection,the sensitivities of ADA+IFN-γ,ADA+IL-2,IFN-γ+IL-2,and ADA+IFN-γ+IL-2 were 69.43％(134/193),75.13％(145/193),44.04％(85/193),and 68.91％(133/193),respectively,while the specificities were 80.00％(128/160),75.00％(120/160),81.25％(130/160),and 82.50％(132/160),respectively.The positive predictive values were 80.72％(134/166),78.38％(145/185),73.91％(85/115),and 82.61％(133/161).The corresponding AUC values were 0.807,0.800,0.644,and 0.808,and Kappa values were 0.387,0.452,0.249,and 0.410,respectively.Conclusion:Pleural fluid ADA alone demonstrates high diagnostic efficiency for TBP.When combined with whole blood IFN-γ and IL-2,it further improves the specificity and positive predictive value without compromising diagnostic performance,thereby increasing detection rates and reducing missed diagnoses.The combined detection strategy can be applied in the clinical diagnosis of TBP to maximize its diagnostic advantages.关键词
结核,胸膜/腺苷脱氨酶/干扰素类/白细胞介素2/诊断Key words
Tuberculosis,pleural/Adenosine deaminase/Interferons/Interleukin-2/Diagnosis分类
医药卫生引用本文复制引用
魏黛珏,同重湘..胸腔积液腺苷脱氨酶、全血γ-干扰素和白细胞介素2检测对结核性胸膜炎的诊断价值[J].结核与肺部疾病杂志,2025,6(5):525-531,7.基金项目
兰州市科技发展指导性计划项目(2024-9-214) （2024-9-214）
兰州市卫生健康行业科研项目(A2024032) Guidance Program of Lanzhou Science and Technology Development(2024-9-214) （A2024032）
Research Project for the Lanzhou Healthcare Sector(A2024032) （A2024032）
