The Diagnostic Value Of Joint Detection With Bacteriophage Phage, ADA And TB-Ab-IgG For Tuberculous Pleural Effusion

Today tuberculos is one of the most threatening infectious diseases in the world; it has the highest mortality rate in infectious diseases that caused by one single cause; it is the first infectious killer in developing countries and it is a serious public health problem. As a result of the biological characteristics of TB and social factors, and the neglect of tuberculosis by the countries around the world nearly 20 years, tuberculosis caused by a global recovery.It led to great importance attached by the international community. The World Health Organization has focused on the control of tuberculosis as one of the infection disease. According to The World Health Organization reported that the world is only one third of people have been infected with mycobacterium tuberculosis, there are activity tuberculosis patients of about 20 million in global, The incease of tuberculosis patients is about 800-1,000 million people each year and about three million people died of tuberculosis. The number of active pulmonary tuberculosis patients in China ranked the second in the world, rank next to India. The tuberculosis infection rate is higher than that of the world's population 1/3 level. Estimates the current number of active pulmonary tuberculosis is about 4.5 million patients all over the country. Tuberculosis mortality rate was 9.8/10 million across the country. Every year 130,000 people died of tuberculosis. It can be seen the importance and urgency for the prevention and treatment of tuberculosis in our country. In treatment, The World Health Organization (WHO) develop and start to special projects to actively promote the full supervision of short-course chemotherapy as a national core of planning for the tuberculosis in order to curb tuberculosis. However, in the diagnosis, especially in regard to the diagnosis of extrapulmonary tuberculosis, it lacks for precise diagnosis and effective measures. Tuberculous pleurisy is more common among Extrapulmonary tuberculosis. If not promptly dealt with, it will affect the type of treatment and prognosis of patients, and may become a new source of infection. The tuberculosis and cancer pleural are the most common cause of formation of effusion, there are different treatment and prognosis, so the differential diagnosis between the two effusion is particularly important. Diagnosis of tuberculous pleurisy indicators include hydrothorax check acid-fast bacilli smear, pleural biopsy, thoracoscopy. Pleural effusion smears check the lower detection rate of TB. The positive rate of pleural biopsy is not high, and percutaneous pleural biopsy has its blindness, it is difficult to get lesions of pleural in one time. So there is less patients accept to it. Thoracoscopy of pleural effusions is an effective inspection and with a higher rate of diagnosis. However, as the check is wounded, it can cause bleeding and pneumothorax and partial pleural metastasis of tuberculos or tumor. Thus limited the application of it in clinic. For these reasons, the diagnosis and treatment of disease are greatly affected .It is not conducive to the control of tuberculosis.With the development of medicine in recent years, scholars and foreign experts study related to the measure targets for tuberculosis especially tuberculous pleurisy in immunology, cell biology, molecular biology and other fields. These studies provides a new way for the diagnosis and the differential diagnosis of tuberculous pleurisy.Objective: To discuss the value of examining bacteriophage phage, ADA, TB-IgG in diagnosing tuberculous pleural effusion. The expression level of bacteriophage phage in the pleural effusion is used for diagnosis and distinguish in tuberculous pleural effusion.It is expected to provide a more effective and accurate way for diagnosis and differential diagnosis of tuberculous pleural effusion.Methods: In this study, 104 patients including 60 tuberculous pleurisy, 44 cancerous pleural effusion were layout into two groups: tuberculous pleural effusion group (group I), cancerous pleural effusion group II (group II). The quantitative detection of ADA was made by automatic biochemical analyzer instrument of Hitachi 7180. The TB antibody measured with the colloidal-gold detection method; The application of technology of phage amplified biologicalfor detection of bacteriophage phage. All operation steps are carry out strictly accordance with the equipment and manual. Furthermore, the diagnostic worthiness of ADA in tuberculous and malignant pleural effusions used of receiver operating characteristic curve (ROC curve) done an evaluation.Results:①The serum contents of ADA in the group of tuberculous pleural effusion and malignant pleural effusions were 33.89±7.11U/L; 27.76±7.16U/L; by statistical analysis, which showed significant differences between each groups (P<0.001).②The pleural effusion contents of ADA in the group of tuberculous pleural effusion and malignant pleural effusions were 47.58±11.15U/L; 26.75±11.14U/L; by statistical analysis, which showed significant differences between each groups (P<0.001). P/S in group I were 1.40±0.18 while in group II were 0.94±0.27. The former is more than 1 and the later is less than 1. They are meaningful to diagnosis and differential diagnosis for tuberculosis and malignant pleural effusions.③The positive cases of bacteriophage phage in the group of tuberculous pleural effusion and malignant pleural effusions pleural effusion were 29 cases and 4 cases; The statistical analysis are that X2 value is 18.046 and significant difference between group I and II (P<0.001).④The positive cases of antibody (TB-Ab-IgG) in the groupⅠa ndⅡwere 29 cases and 4 cases; The statistical analysis are that X2 value is 28.94 and significant difference between group I and II (P<0.001).⑤the measure of phage, ADA, TB-Ab-IgG and serum ADA in which any two or three in line with the standards can be diagnosed, the sensitivity, specificity and authenticity were 91.7%, 86.4% and 89.4%.Conclusion: Through the research, it is concluded that the application of Phage biological amplification for check Mycobacterium tuberculosis is a new method in the diagnosis and distinguish diagnosis of mycobacterium tuberculosis, it has significant value and with rapid, sensitive, accurate, simple, convenient, safe characteristic. have. The Combined Detection of Phage, ADA and TB-Ab-IgG can improve the detection rate, diagnosis rate and accuracy of the tuberculous pleural effusion. Thus it is benefit to the distinguish diagnosis and application for the tuberculosis and malignant pleural effusions.