结核性胸膜炎的临床诊断评估

被引:10
作者
范琳
肖和平
机构
[1] 同济大学附属肺科医院
关键词
结核,胸膜; 临床评估; LR+;
D O I
暂无
中图分类号
R521.7 [胸膜炎];
学科分类号
摘要
目的探讨结核性胸膜炎(PT)临床诊断的评估方法。方法对140例胸腔积液的住院病人(其中70例确诊PT及70例确诊非PT)进行回顾性分析,计算胸液ADA、蛋白定量、淋巴细胞比值、血与胸液结核抗体、年龄、发热六个指标诊断PT的似然比(LR)以及灵敏度、特异度、阳性预测值和阴性预测值。结果胸液ADA最佳临界值的LR+值最高,其次是胸液与血结核抗体、年龄、胸液淋巴细胞比值、胸液蛋白、发热,若达到此六项变量的最佳诊断界值,患PT的可能性为99%以上,若此六项变量均阴性,患PT的可能性则下降为1%以下,只要考虑此六项中的任何四项变量达到最佳诊断界值,临床判断为PT的可能性可达97%。结论联合此六项指标可进行PT的临床诊断评估,有利于指导临床治疗。
引用
收藏
页码:330 / 333
页数:4
相关论文
共 8 条
[1]  
Does pleural tuberculosis dis-ease pattern differ among developed and developing countries. Ibrahim WH,Ghadbanw,KhinjiA,et al. Respiratory Medicine . 2005
[2]  
Simple methodfor rapid diagnosisof tuberculosis pleuritis:a statistical approach. Ghanei M,Aslani J,Bahrami H,et al. Asian Cardiovasc Tho-rac Ann . 2004
[3]  
Diagnostic value of pleural fluidadenosine deaminase activityintuberculous pleurisy. Chen ML,Yu WC,Lam CW,et al. Clinica Chimica Acta . 2004
[4]  
Differentiating tuberculous from malignant pleuraleffusions:a scoring model. Porcel JM,Vives M. Medical Science Monitor . 2003
[5]  
The value of pleural fluid anti-A60 IgMin BCG-vaccinatedtuberculous pleurisy patients. Kunter E,Cerrahoglu K,Ilvan A,et al. Clin Mi-crobiol Infect . 2003
[6]  
Diagnostic toolsintuber-culous pleurisy:a direct comparative study. Diacon AH,Van de Wal BW,Wyser C,et al. European Respiratory Journal . 2003
[7]  
Adenosine Deaminase in the Diagnosis of Tubercu-losis Pleural Effusion:Is It Really an Idial Test?A World of Caution. Laniado-Laborin R. Chest . 2005
[8]  
What is the probability of a PatientPresenting a Pleural Effusion dueto Tuberculosis. Neves DD,Dias RM,Cunha AJLA. BJID . 2004