372内科急危重症杂志2222年第26卷第5期血清血管紧张素转化酶水平联合结核T-2POT 检测 对活动性肺结节病的诊断价值* **基金项目:国家自然科学基金面上项目(81670035)* 通信作者:王坚苗,Email :wangjiabmiaoC014@ 167. com 华中科技大学同济医学院附属同济医院高姝佩陈晋卿王坚苗*,武汉632232
甘胆酸
摘要 目的:探讨血清血管紧张素转化酶(ACE)联合结核感染T 细胞斑点试验(T-SPOT )中的结核特异性抗原 (TBA/)与植物血凝素(PHA )比值对活动性肺结节病的诊断价值。方法:回顾性选取活动性肺结节病患者44例为病 例组,选取患者33例和非结节病非结核患者22例为对照组,比较3组患者血清ACE 水平和TBA//PHA 比 值,采用受试者工作特征(ROC)曲线下面积(AUC )评价血清ACE 水平、TBAy/PHA 比值及两者联合对活动性肺结节 病的诊断价值。结果:活动性肺结节病组患者血清ACE 水平显著高于对照组(P<0. 01),组患者TBAy/PHA 比值显著高于活动性肺结节病组和非结节病非结核对照组(均P<0.41)o 以非结节病患者为对照,血清ACE 水平、 TBAy/PHA 比值及两者联合对活动性肺结节病诊断的AUC 分别为0. 571、4. 723和0. 971,以患者为对照,其 AUC 分别为4C55、4C23和0C30,以非结节病非结核患者为对照,其AUC 分别为0C94、0C73和0C02。结论:血 清ACE 水平和结核T-2POT 中的TBAy/PHA 比值两者联合对活动性肺结节病具有更高的诊断价值。蔡邕书论关键词 血管紧张素转化酶;结核感染T k 胞斑点试验;肺结节病;诊断价值
中图分类号 R461 文献标识码 A DO) 10. ^765//0wzzzz24204545
Diaanostic value of servm angiotensin ccnverting enzyme combiner with thbercclosis T-2POT for active pulmonarv surccinosis GAO Shu-pet, CHEN Jin-qing , WANG Jian-pinn *. Tongji Hospitnl , Tongji MeCihl College , Huazhong Unn versity of' Science ang Tehoolofa , WuUan 430032 , Chinn
Abstrect Objective : To ixvestigate the diaaxostic value ol serum angiotexsio couverhng exzyme (ACE) combixed with ratio ol wUeuhhsisspecific axtigex (TBAy) to phytohemag/htinio ( PHA ) io T-2POT for active pulhoxau sarcoidosis. Methods : The patiexts with active pulmoxau sarcoidosis were selected retrospecTvely as the case auep ( n 二 33) , those with tuUeuhlosiz ( n 二 33) and those with xox-sauoidosis xou-wUeuhhsis( n 二 20) served as the coutrol auep. The levels oh serC um ACE and TBAy/PHA ratio were compared. The receiver operahng characteristic (ROC) cube was used to evaluate the diaaxostic value oh ACE, TBAy/PHA ratio and their combixadox. Results : The levels oh ACE io active pulmoxau sauoido- sis auep were significaxtly higher thax io the coutrol auep ( P < 0C1 ). The TBAy/PHA ratio io the tuUebhhsis auep was significaxtly higher thax io active sarcoidosis auep and you-SCboidosis xox-wUeuhhsis auep ( P < 0. 41 ). Using xou-sar- coidosis patiexts a
债券融资s coutrols , the area under the ROC curve (AUC) oh serum ACE, TBAy/PHA uhe and their combixatiox for the diapyosis oh active pulhoxau sarcoidosis was 0. 371, 0. 723 and 0. 971, respectively. Using pulhoxau wUeuhhsis pahexts as coutrols , the AUC oh serum ACE , TBAy/PHA ratio and their combixadox for the diapyosis oh active pulhoxau sarcoidosis was 0. 355 , 0. 563 and 0. 930 , respectively. Using xoe-SCUoidosis xox-wUeuhhsis patiexts as coutrols , the AUC oh serum ACE , TBAy/PHA ratio and their combixadox for the diaaxosis oh active pulhoxau sarcoidosis was 0. 854 , 0. 573 and 0. 907 , respecTvely. Coxchsioxs : The combixadox oh serum ACE and TBAy/PHA ratio io T-2POT has a higher diaa- xostic value for active pulhoxau sarcoidosis.
Key wo V s Angiotexsio couveUing exzyme ; TuUebhhsis T-SPOT ; Pulhoxau sarcoidosis ; Diapyostie value 结节病是一种以非干酪样坏死性上皮样细胞肉 芽肿为病理特征的系统性肉芽肿性疾病,以肺及胸
内淋巴结受累最常见[72 ] o 由于其非特异性的临床
精加力症状及影像学表现,常常会导致误诊[31 ] 0我国结
核发病率高,肺结节病与在影像及病理学上
颇为相似,有时鉴别非常困难。结节病肉芽肿病灶
内上皮样细胞可释放血管紧张素转化酶(angiotensin convaOing enzyma , ACE ),可作为活动性的判断指 标「5 ]。糖皮质激素是主要药物,因此在前
需排除结核,而结核感染T 细胞斑点试验(TCPOT )
被认为对结核具有较高的诊断价值血1 ]。本文通过 回顾性病例分析,探讨血清ACE 水平联合TCPOT 对 动性肺 病的 价 0资料与方法一般资料 选择2214年(月~ 2219年7月在
劳思光
华中科技大学同济医学院附属同济医院呼吸科住院
的46例活动性肺结节病患者的临床资料。病例纳
铸铁工艺
入标准:①符合肺结节病的诊断标准"]:②住院期 间检测了血清ACE 水平和结核T-SPOT ;③诊断后