P-选择素等多项指标检测在胸腔积液鉴别中的应用价值

摘要/Abstract

摘要： 目的分别检测结核性与恶性胸腔积液(以下简称胸液)中检测P-选择素、IL-1α、sFas、sFasL、AM(肾上腺髓质素)含量并与癌胚抗原(CEA)比较,探讨各检测方法及联合检测在结核性与恶性胸液鉴别诊断中的价值。方法在结核性与恶性胸液中,应用ELISA法检测P-选择素、IL-1α、sFas、sFasL的含量;用放射免疫法(RIA)分别检测AM与CEA含量,对所得数据进行统计学处理。结果(1)结核性胸液中P-选择素、IL-1α含量均明显低于恶性胸液组,分别为(t=8．71,P＜0．01),(t= 6．80,P＜0．01);(2)结核性胸液中sFas、sFasL含量均明显高于恶性胸液组,分别为(F=4．451,t= 6．422,P＜0．001);(F=5．760,t=6．866,P＜0．001);(3)结核性胸液中AM、CEA含量均明显低于恶性胸液组,分别为(t=7．49,P＜0．05);(t=6．37,P＜0．01)。结论P-选择素、IL-1α、sFas、sFasL与AM在对结核性与恶性胸液的鉴别诊断上,敏感性、特异性及临床诊断符合率均高于CEA,有较高的临床实用价值。ELISA法中以P-选择素为优,放免法以AM为优,联合检测可明显提高其临床诊断符合率。

关键词: P-选择素, IL-1α, sFas, sFasL, 肾上腺髓质素(AM), 癌胚抗原(CEA), 胸腔积液,结核, 胸腔积液,恶性, 诊断

Abstract: Objective To evaluate the diagnostic values and clinical significance of detecting P-selectin, IL-1α,soluble Fas,soluble FasL and adrenomedullin(AM)in pleural effusions in different tuberculous pleural effusions and malignant pleural effusions, and compare with CEA. Methods The level of P-selectin,IL-1α, soluble Fas, soluble FasL in tuberculous and malignant pleural effusions were determined by Enzyme-linked immunosorbent assay(ELISA) ,and that of AM and CEA were determined by radioimmunoassay(RIA). Results (1)The level of P-selectin and IL-1a in tuberculous pleural effusions was markedly lower than that in malignant pleural effusions( t= 8.71, P＜0.001) . (2)The level of sFasL and sFas in tuberculous pleural effusions was markedly higher than that in malignant pleural effusions ( t=6.80,P＜0.001;F= 4.451,t= 6.422, P＜0.001) . (3)The level of AM and CEA in tuberculous pleural effussions was markedly lower than that in malignant pleural effusions(t= 7.491, P＜0.05; t= 6.37, P＜0.01). Conclusion The joint detection of P-selectin, IL-1α, sFas,sFasL, AM and CEA might be helpful to differential diagnosis of tuberculosis pleural effusion and malignant pleural effusion.

Key words: P-secectin, IL-1α, sFas, sFasL, adrenomedullin ( AM ), Enzyme-linked immunosorbent assay (ELISA), Radioimmunoassay (RIA), Pleural effusion, tuberculosis, malignant peural effusions, Diagnosis

王英年,刘加洪,孙荣丽,李黎,官明德,于华,马学真,张春玲,赵云峰,王瑞兰,. P-选择素等多项指标检测在胸腔积液鉴别中的应用价值[J]. 中国防痨杂志, 2007, 29(1): 8-11.

Wang Yingnian , Liu jiahong , Sun Rongli, et al.. The clinical diagnostic value of detection of P-selectin, IL-1α, sFas, sFasL, AM in differentiating tuberculous pleural effusions from malignant pleural effusions[J]. Chinese Journal of Antituberculosis, 2007, 29(1): 8-11.

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