The Value Of Detection Of MIP-1α Level And Tuberculosis Infection T Cell Spot Test In Pleural Effusion In The Diagnosis Of Tuberculous Pleurisy And Explore The Critical Value Of MIP-1α

Objectives To explore the best critical value of macrophage inflammatory protein-1 alpha(MIP-1α)level in the pleural effusion in the diagnosis of tuberculous pleurisy,to evaluate the value of MIP-1α level in the pleural effusion in the diagnosis of tuberculous pleurisy;To compare the sensitivity and specificity of pleural effusion MIP-1 alpha test and tuberculosis infection T cell spot test in the diagnosis of tuberculous pleurisy.Methods 98 patients with unexplained pleural effusion from september 2014 to september 2016 in the Second Hospital Affiliated of University of South China were included in this study.Pleural effusion was diagnosed in 95 cases patients by medical thoracoscopy and iopsy of pleura.Three cases patients were removed because of incomplete data.95 cases patients were randomly individed into the tuberculous pleural effusion group(n=67)and malignant pleural effusion group(n=28).Pleural effusion specimen of patients was collected after admission.The level of MIP-1α in pleural effusion was tested by ELISA assay.T-SPOT.TB was accomplished.Area under the curve,the sensitivity and specificity of diagnosis and Youden index were analysed by receiver operating characteristic curve(ROC)assay.The best critical value of MIP-1α level in the pleural effusion was confirmed by ROC assay.The value of detection of T-SPOT.TB in diagnosis of tuberculous pleurisy was analysed.Sensitivity and specificity of the level of MIP-1α in pleural effusion and T-SPOT.TB in diagnosis of tuberculous pleurisy were compared.Results 1.The level of MIP-1α in pleural effusion was significantly i n c r e a s e d(7 4.8 3 ± 4.6 7 p g / m l v s 1 7.5 4 ± 1.3 5 p g / m l)(P < 0.0 5).2.Area under curve of MIP-1α level in pleural effusion was 0.84.The best critical value of MIP-1α level in the pleural effusion for diagnosis of tuberculous pleurisy was 41.23 pg/ml.The sensitivity and specificity of MIP-1α level for diagnosis of tuberculous pleurisy were 86.56% and 82.14%,respectively,Youden index is 0.69.3.Pleural effusion MIP-1α detection and T-SPOT.TB detection have superior value in the diagnosis of tuberculous pleurisy.Compared with the two groups,the sensitivity,specificity,positive predictive value and negative predictive value of tuberculous pleurisy were not statistically significant.(P>0.05).Conclusions MIP-1a pleural effusion detection and T-SPOT.TB detection has higher value in diagnosis and differential diagnosis of tuberculous pleurisy,pleural effusion MIP-1 a critical value of 41.23 pg/ml,has a high sensitivity for the diagnosis of tuberculous pleuritis and specificity.