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目的探讨不同类型结核病患者糖链抗原(carbohydrate antigen,CA)125与CA19-9表达差异及其在不同类型结核病、肺炎诊断中的价值。方法 125例结核病患者为结核病组,其中血行播散型肺结核11例,继发型肺结核73例,结核性胸膜炎22例,肺外结核19例;42例细菌性肺炎患者为肺炎组;同期体检健康者70例为对照组。检测各组血清CA125与CA19-9水平,并进行比较。结果结核病组血清CA125水平[(115.15±23.32)u/mL]高于肺炎组[(45.77±12.20)u/mL]和对照组[(13.74±4.54)u/mL],肺炎组高于对照组,差异均有统计学意义(P<0.05);肺炎组CA19-9水平[(31.20±11.82)u/mL]高于结核病组[(11.65±3.71)u/mL]和对照组[(14.10±3.92)u/mL],结核病组与对照组比较差异无统计学意义(P>0.05);结核性胸膜炎组血清CA125水平[(416.78±159.64)u/mL]高于血行播散型肺结核[(67.54±23.27)u/mL]、继发性肺结核组[(55.01±13.15)u/mL]及肺外结核组[(31.06±10.84)u/mL](P<0.05),继发性肺结核组与血行播散型肺结核组高于肺外结核组(P<0.05),继发性肺结核组与血行播散型肺结核组比较差异无统计学意义(P>0.05);血行播散型肺结核组[(16.44±5.73)u/mL]、结核性胸膜炎组[(15.23±5.77)u/mL]、继发型肺结核组血清CA19-9水平[(11.48±3.68)u/mL]均高于肺外结核组[(5.37±1.26)u/mL](P<0.05),血行播散型肺结核组、结核性胸膜炎组高于继发型肺结核组(P<0.05),血行播散型肺结核组与结核性胸膜炎组比较差异无统计学意义(P>0.05)。结论 CA125、CA19-9对结核病与细菌性肺炎鉴别诊断有重要意义,二者联合检测对不同类型肺结核的鉴别具有参考价值。
Objective To investigate the differences of carbohydrate antigen (CA) 125 and CA19-9 between different types of tuberculosis patients and their diagnostic value in different types of tuberculosis and pneumonia. Methods Totally 125 TB patients were tuberculosis patients, including 11 cases of hematogenous disseminated tuberculosis, 73 cases of secondary tuberculosis, 22 cases of tuberculous pleurisy and 19 cases of extrapulmonary tuberculosis. Among them, 42 cases of bacterial pneumonia were pneumonia group. In the same period, 70 cases as control group. The levels of serum CA125 and CA19-9 in each group were detected and compared. Results The level of serum CA125 in TB group was significantly higher than that in control group [(115.15 ± 23.32) u / mL] [(45.77 ± 12.20) u / mL] and control group [(13.74 ± 4.54) (P <0.05). The level of CA19-9 in the pneumonia group [(31.20 ± 11.82) u / mL] was significantly higher than that in the tuberculosis group [(11.65 ± 3.71) u / mL] 3.92) u / mL], there was no significant difference between tuberculosis group and control group (P> 0.05); serum CA125 level in tuberculous pleurisy group [(416.78 ± 159.64) u / mL] was higher than that in hematogenous disseminated tuberculosis 67.54 ± 23.27) u / mL], secondary pulmonary tuberculosis (55.01 ± 13.15) u / mL and extrapulmonary tuberculosis (31.06 ± 10.84) u / mL, respectively And hematogenous disseminated pulmonary tuberculosis group was higher than extrapulmonary tuberculosis group (P <0.05), there was no significant difference between secondary tuberculosis group and hematogenous disseminated pulmonary tuberculosis group (P> 0.05); hematogenous disseminated pulmonary tuberculosis group [ (16.44 ± 5.73) u / mL], tuberculous pleurisy group [(15.23 ± 5.77) u / mL], and the level of serum CA19-9 in secondary tuberculosis group [(11.48 ± 3.68) u / mL] Group [(5.37 ± 1.26) u / mL] (P <0.05), hematogenous disseminated pulmonary tuberculosis and tuberculous pleurisy were higher than those of secondary lung Nuclear group (P <0.05), hematogenous disseminated pulmonary tuberculosis and tuberculous pleurisy groups was not statistically significant (P> 0.05). Conclusions CA125 and CA19-9 are of great significance in the differential diagnosis of tuberculosis and bacterial pneumonia. The combined detection of them has reference value for different types of pulmonary tuberculosis.