胸液γ-干扰素和α-肿瘤坏死因子检测对结核性胸膜炎诊断价值的探讨

中国防痨杂志 ›› 1999, Vol. 21 ›› Issue (2): 91-93.

胸液γ-干扰素和α-肿瘤坏死因子检测对结核性胸膜炎诊断价值的探讨

王敬萍；刘东洋；古淑香；马屿；

北京市结核病?胸部肿瘤研究所;

收稿日期:1998-12-14 修回日期:1999-01-21 出版日期:1999-02-10 发布日期:1999-02-10

Significance of detecting interferon (IFN) gamma and tumour necross factor(TNF) alpha concentrations in pleural effusion in the diagnosis of tuberculous pleurisy

Wang Jingping,Liu Dongyang,Gu Shuxiang,et al.

Beijing Tuberculosis & Thoracic Tumour Research Institute,Beijing 101149

Received:1998-12-14 Revised:1999-01-21 Online:1999-02-10 Published:1999-02-10

摘要/Abstract

摘要： 目的检测结核性胸膜炎及恶性胸膜炎患者血清与胸液的γ-干扰素和α-肿瘤坏死因子水平,探讨对结核性胸膜炎诊断的临床价值?方法采用酶联免疫吸附法(ELISA)检测41例结核性胸膜炎?40例恶性胸膜炎患者血清及胸液和41例健康对照组血清的γ-干扰素和α-肿瘤坏死因子水平?结果结核性胸膜炎患者两者含量(427.3±56.8?184.7±64.7pg/ml)明显高于恶性胸膜炎组(45.6±20.3?50.5±18.7)(P<0.01),且重叠性很小;而两组血清含量很低并相近,与健康对照组比较无显著差异(P>0.05)?γ-干拢素和α-肿瘤坏死因子作为诊断结核性胸膜炎的敏感性?特异性?准确性分别为100.0%?97.5%?98.8%及87.8%?90.0%?88.9%?结论检测胸液γ-干扰素和α-肿瘤坏死因子对诊断结核性胸膜炎有较大的辅助意义?

关键词: 结核.胸膜炎, γ-干扰素.α-肿瘤坏死因子

Abstract: Objective To eveluate the concentration of inferon(IFN) gamma and tumour necrosis factor(TNF) alpha in pleural effision in the diagnosis of tuberculous pleurisy.Method IFN γ and TNF α of serum and pleural effusion in 41 patients with tuberculous pleurisy,40 patients with malignant pleurisy and 41 healthy individuals serum were detected by ELISA method.Result The concentration of IFN γ and TNF α were much higher in tuberculous pleurisy(427.3±56.8?184.7±64.7),than malignant pleurisy(45.6±20.3,50.5±18.7) P<0.01.The serum concertration of them were low in two groups( P >0.05).The sensitivity,specificity,accuracy of IFN γ in the diagnosis of tuberculosis pleurisy were 100.0%,97.5%,98.8%,respectively.Similarly,those of TNF α for the diagnosis were 87.8%,90.0%,88.9%,respectively.Conclusion Our results indicate that simultaneous measurement of IFN γ and TNF α in pleural effusion might be helpful for the diagnosis of tuberculous pleurisy.

Key words: Tuberculosis, pleural IFN-γ, TNF-α

王敬萍, 刘东洋, 古淑香, 马屿, . 胸液γ-干扰素和α-肿瘤坏死因子检测对结核性胸膜炎诊断价值的探讨[J]. 中国防痨杂志, 1999, 21(2): 91-93.

Wang Jingping,Liu Dongyang,Gu Shuxiang,et al.. Significance of detecting interferon (IFN) gamma and tumour necross factor(TNF) alpha concentrations in pleural effusion in the diagnosis of tuberculous pleurisy[J]. Chinese Journal of Antituberculosis, 1999, 21(2): 91-93.

参考文献

1 Raja DG. Modification of the technique of percutaneous pleural biopsy using the Abram9 needle. Br J Dis Chest, 1980,74 (1)：285-286.
2 De Wit D, Maurtents G,Steyn L.A comparative study of the poly-merase chain reaction and conventional procedures for the diagnoeia of tuberculous pleural dffuition. Tubercle arid Lung Disease,1992,73(4)：262-267.
3 张敦华主编。实用胸膜疾病学。上海：上海医科大学出版社，1997,149-155.
4 Miyazaki, Y,Koga H,Kohno S,et al. Nested polymerase chain reac-tion far detection of mycobacterium tuberculosis in clinical sanples.J Clin Microbiol, 1993,31(4) :2228-2232.
5 Ribera E,Ocana I,Martinez-Vazquez JM,et al.High level of inter-feron-gamma in tuberculous pleural effiiaion. Chest, 1988,93(2):308-311.
6 Barnes PF, Fong S,Brennan PJ, et al. Local production of tumour necrosis factor and IFN-y in tuberculous pleuritis. J Immunol v1990,145(7)： 149-154.
7 Shimokata K, Saka H, Murate T, et al. Cytikine content in pleural effusion. Comparison between tuberculous and carcinomatous pleurisy. Chest, 1991,99(5): 1103-1107.
8 Ogawa k, Koga H,Hiiakaia Y,et al. Differential diagnosis of tuber-culous pleurisy by measurement of cytokine concentration in pleural effiision.Tubercle and Lung Disease, 1997,78(1)34.
9 Shimokata K,kawachi Hy Kiahirooto et al. Local cellular immuni-ty in tuberculous pleurisy. Am Rev Rev Respri Disease, 1982,126(8):822-834.
10 Nadal D,Leppert D,Frei K,el al.TNF infections meningilis. Arch Dis Child, 1989,64(6): 1247-1256.
11 Baughman RP, Louer EE. An inhibitor of tumour necrosis factor in pleural effusion. J Lab Clin Med, 1991,118(2) ：326-346.
12 Barnes PF,Mistry SD,Cooped CL,et al. Conpartmentali2ation of a CD4+ T lymphocyte subpopulation in tuberculous pleuritis. J Im-munol,1989,142(3)： 1114-1126.