The Diagnostic Value Of Combined Detection Of Pleural Effusion ADA、serum CA125 And Serum T-spot·TB For The Tuberculous Pleurisy

Objective:The differences of pleural effusion ADA,serum CA125 and serum T-spot·TB levels in patients with tuberculous pleural effusion and non-tuberculous pleural effusion were compared and analyzed to clarify their clinical value for the diagnosis of tuberculous pleural effusion.Method:According to the include and exclude criterion,88 cases of tuberculous pleural effusion and 126 cases of non-tuberculous pleural effusion were retrospectively collected from January 2018 to December 2020 in the department of Respiratory Medicine of the First Hospital of Jinlin University.The group of non-tuberculous pleural effusion was divided into two subgroups including the malignant pleural effusion group and the parapneumonic effusion group.The differences in age,sex,symptoms,basic diseases,symptoms and pleural effusion ADA,serum CA125,serum T-spot·TB among the three groups were compared,and the sensitivity and specificity of diagnosis were analyzed.Result:1.Comparison of general information:There was no statistical difference in age and sex among all groups(P>0.05).2.Comparison of basic diseases:The patients of the three groups showed no significant difference in hypertension,diabetes,cardiovascular and cerebrovascular diseases(P>0.05).3.Comparison of clinical symptoms:(1)There was no statistically significant difference in cough,sputum,chest pain,dyspnea and weight loss among the three groups(P>0.05).(2)Compared with the non-tuberculous pleural effusion group,the tuberculous pleural effusion group was more prone to be characterized by sleep hyperhidrosis(P<0.05),while there was no differences between the non-tuberculous pleural effusion subgroups(P>0.05).(3)Compared with the parapneumonic pleural effusion group,the tuberculous and malignant pleural effusion groups were more likely to show weight loss(P <0.05),and there was no statistically significant difference between the tuberculous and malignant pleural effusion groups(P>0.05).(4)Compared with the malignant pleural effusion group,the tuberculous and parapneumonic pleural effusion groups were more prone to fever(P < 0.05).There was no significant difference between the tuberculous and parapneumonic pleural effusion groups(P>0.05).4.Comparison of laboratory indicators(1)The pleural effusion ADA in the tuberculous pleural effusion group was significantly higher than that in the malignant and parapneumonic pleural effusion groups(P < 0.05).The pleural effusion ADA in the parapneumonic pleural effusion group was higher than that in the malignant pleural effusion group(P <0.05).(2)The number of positive cases of serum T-spot·TB in the tuberculous pleural effusion group was significantly higher than that in the non-tuberculous pleural effusion group(P <0.05),and there was no difference between the non-tuberculous pleural effusion subgroups(P>0.05).(3)Compared with the parapneumonic pleural effusion group,the serum CA125 of the tuberculous pleural effusion group increased(P < 0.05)and compared with the malignant pleural effusion group,the serum CA125 of the tuberculous pleural effusion group decreased(P < 0.05).5.Comparison of diagnostic value of pleural effusion ADA,serum CA125 and serum T-spot·TB in tuberculous pleural effusion(1)Single index:The sensitivity and specificity of pleural effusion ADA were95.5%,76.2%(P < 0.05).The sensitivity and specificity of serum CA125 were 91.9%,41.8%(P < 0.05).The sensitivity and specificity of serum T-spot·TB were 60.2%,83.3%(P < 0.05).(2)Combined detection of the two indicators:The sensitivity and specificity of pleural effusion ADA combined with serum T-spot·TB were 56.8%,96.0%(P < 0.05).The sensitivity and specificity of pleural effusion ADA combined with serum CA125 were 80.7%,89.7%(P < 0.05).The sensitivity and specificity of serum T-spot·TB combined with serum CA125 were 52.3%,87.3%(P < 0.05).(3)Combined detection of the three indicators:The sensitivity and specificity of pleural effusion ADA combined with serum T-spot·TB and serum CA125 were 48.9%,97.6%(P < 0.05).Conclusion:1.There are certain defects in the preliminary diagnosis of tuberculous pleural effusion by single detection of pleural effusion ADA,serum T-spot·TB or serum CA125.2.The specificity of any two indexes of pleural effusion ADA,serum CA125 and serum T-spot·TB to combine in the preliminary diagnosis of tuberculous pleural effusion was higher than that of a single index.The specificity of pleural effusion ADA combined with serum T-spot·TB was higher,which could improve the diagnostic accuracy,while the sensitivity of pleural effusion ADA combined with serum CA125 was higher,which could improve the screening effect.3.The specificity of the combined detection of pleural effusion ADA,serum CA125 and serum T-spot·TB in the preliminary diagnosis of tuberculous pleural effusion was higher than that of the single index and the combined detection of two indexes,which could further improve the diagnostic rate of tuberculous pleural effusion.