Abstract:

Objective　To analyze the value of color Doppler ultrasound combined with adenosine deaminase (ADA) and transforming growth factor-β1 (TGF-β1) in the diagnosis of patients with tuberculous pleurisy (TBP). Methods　One hundred and fifty patients with unknown pleural effusion treated at General Medical Xi'an Hospital from May 2021 to September 2023 were selected. Color Doppler ultrasonography was performed on all the patients. The level of TGF-β1 was detected by the enzyme linked immunosorbent assay, and the level of ADA by the rate method. According to whether they were diagnosed with TBP, the patients were divided into a TBP group and a non-TBP group. The basic data of the two groups were compared. The factors affecting the diagnosis of TBP were analyzed the binary logistic stepwise regression model. The receiver operating characteristic curve (ROC) was plotted to evaluate the value of color Doppler ultrasound combined with ADA and TGF-β1 in the diagnosis of TBP. χ² and t tests were used for the statistical analysis. Results　Among the 150 patients, 64 patients had TBP, accounting for 42.67%. The peak systolic velocity (PSV) and levels of ADA and TGF-β1 in the TBP group were higher than those in the non-TBP group, and the resistance index (RI) was lower (all P<0.05). The binary logistic stepwise regression model analysis showed that PSV [OR=1.438 (95%CI 1.198-1.725)], ADA level [OR=1.157 (95%CI 1.077-1.242)], TGF-β1 level [OR=1.124 (95%CI 1.064-1.187)], and RI [OR=0.022 (95%CI 0.004-0.129)] were the influential factors in the diagnosis of TBP (all P<0.05). The ROC analysis showed that the sensitivities of ADA, TGF-β1, PSV, and RI in the diagnosis of TBP were 70.3%, 68.8%, 58.70%, and 62.5%, respectively; the specificities were 64.3%, 66.7%, 67.9%, and 65.5%, respectively. The value of the combination of ADA, TGF-β1, PSV, and RI in the diagnosis of TBP was higher (area under the curve=0.878). Conclusion　Color Doppler ultrasound and ADA and TGF-β1 in pleural effusion have high diagnostic efficacies in the diagnosis of TBP, and the combined diagnosis value is high.

Key words:

Color Doppler ultrasound, Pleural effusion, Adenosine deaminase, Transforming growth factor-β1, Tuberculous pleurisy, Diagnosis

摘要：

目的　分析彩色多普勒超声联合胸腔积液腺苷脱氨酶（adenosine deaminase，ADA）、转化生长因子-β1（transforming growth factor-β1，TGF-β1）诊断结核性胸膜炎（tuberculous pleurisy，TBP）患者的价值。方法　选取2021年5月至2023年9月因不明原因胸腔积液在通用医疗西安医院就诊的150例患者。对患者进行彩色多普勒超声检查。酶联免疫吸附试验检测TGF-β1水平，速率法测定ADA水平。根据是否确诊为TBP将患者分为TBP组和非TBP组。比较两组基础资料。采用二元logistic逐步回归模型分析影响诊断TBP的因素。受试者操作特征曲线（ROC）分析彩色多普勒超声联合胸腔积液ADA、TGF-β1诊断TBP的价值。采用χ²检验、t检验进行统计分析。结果　150例患者中，有64例TBP患者，占比42.67%。TBP组收缩期血流速度（peak systolic velocity，PSV）和ADA、TGF-β1水平均高于非TBP组，阻力指数（resistance index，RI）低于非TBP组（均P<0.05）。二元logistic逐步回归模型分析结果显示，PSV［OR=1.438（95%CI 1.198～1.725）］、ADA水平［OR=1.157（95%CI 1.077～1.242）］、TGF-β1水平［OR=1.124（95%CI 1.064～1.187）］、RI［OR=0.022（95%CI 0.004～0.129）］是诊断TBP的影响因素（均P<0.05）。ROC分析显示，ADA、TGF-β1、PSV、RI诊断TBP的灵敏度分别为70.3%、68.8%、58.7%、62.5%，特异度分别为64.3%、66.7%、67.9%、65.5%。ADA、TGF-β1、PSV、RI联合诊断TBP的价值较高（曲线下面积=0.878）。结论　彩色多普勒超声、胸腔积液ADA和TGF-β1对TBP具有较高的诊断效能，联合诊断TBP的价值较高。

关键词:

彩色多普勒超声, 胸腔积液, 腺苷脱氨酶, 转化生长因子-β1, 结核性胸膜炎, 诊断