胸腔镜确诊的胸腔积液ADA及γ-干扰素释放试验结果分析

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• 论文作者：刘青 ; 王继鹏 ; 宋应键 ; 王立新
• 年：2016
• 作者机构：南京医科大学附属淮安第一医院;
• 论文关键词：胸腔积液 ; 胸腔镜 ; γ-干扰素释放试验 ; 腺苷脱氨酶
• 英文论文关键词：Pleural effusion ; Thoracoscopy ; interferon gamma releasing assays ; Adenosine deaminase
• 会议召开时间：2016-11-25
• 会议录名称：湖南中医药大学学报2016/专集：国际数字医学会数字中医药分会成立大会暨首届数字中医药学术交流会论文集
• 语种：中文
• 分类号：R561.3
• 学会代码：HNZY
• 会议名称：国际数字医学会数字中医药分会成立大会暨首届数字中医药学术交流会
• 会议地点：中国广东珠海
• 主办单位：国际数字医学会、Digital Chinese Medicine
• 学会名称：湖南中医药大学期刊杂志社
• 页数：1
• 文件大小：2055k
• 原文格式：D
• 会议级别：全国

摘要

目的回顾性分析胸腔镜确诊的胸腔积液患者腺苷脱氨酶(ADA)及静脉血γ-干扰素释放试验(T-SPOT)检测,评价T—SPOT、ADA等在不明胸腔积液诊断中的价值。方法顾性分析2014-2016淮安市第一人民医院呼吸科46例经内科胸腔镜术确诊的胸腔积液患者,其中男30例,女16例,年龄13~74岁,平均(47±17)岁,比较胸腔镜下表现及ADA、T-SPOT检测结果。结果 1.内科胸腔镜下表现:病理诊断结核性胸膜炎32例,镜下多表现为壁层胸膜粟粒样结节、粘连、灰白色坏死;恶性肿瘤转移9例,多表现为大小不等的结节,有菜花样、串状;5例为炎性病变。2.结核性胸腔积液组ADA、T-SPOT较恶性胸腔积液组高。3.ADA及T-SPOT阳性患者有28例为结核性胸膜炎。结论血T—SPOT联合胸水ADA检测可提高诊断结核性胸膜炎的敏感性。内科胸腔镜简单、安全,对不明原因胸腔积液的诊断有重要价值。
Objective:Retrospective analysis of the value of adenosine deaminase(ADA) and interferon gamma releasing assays(T-SPOT) in pleural effusion diagnosed by thoracoscopy,andevaluate the value of T-SPOT and ADA in pleural effusion. Methods: A retrospective analysis of 46 pleural effusion diagnosed by thoracoscopy(30 males and 16 females,age 13—74 years)in huai'anfirst peoples hospital from 2014 to 2016 were performed.Compare the value of ADA and T-SPOT. Results: Tuberculous pleurisy was manitested as diffuse pleural congestion and miliary changes,multiple small gray—white nodules, fibrin deposition.The endoscopic findings of malignant pleural effusion mostly showed nodules of varying sizes.The nodules could be cauliflower—like.The pleuralfluid ADA and T-SPOT in the tuberculosis group were higher than the malignant group. Conclusion:The combined detection of ADA and T-SPOT has important significance in tuberculosis pleuraleffusion. Medical thoraeoscopy is a relatively safe procedure and has an important application value in the diagnosis of unexplained pleural effusion.

引文

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