摘要
目的：探讨胸腔积液和血清中腺苷脱氨酶鉴别诊断结核性胸膜炎及恶性胸腔积液的价值。方法：因胸腔积液住院,经胸腔镜检查和胸膜活检病理确诊为结核性胸腹炎患者（结核组）42例和恶性胸腔积液患者（恶性组）38例,分别检测2组胸腔积液及血清中腺苷脱氨酶活性,应用ROC曲线确定结核性胸膜炎患者胸腔积液腺苷脱氨酶的最佳临界值。结果：结核组胸腔积液腺苷脱氨酶活性、胸腔积液腺苷脱氨酶与血清腺苷脱氨酶比值分别为（48±25）u/L和4.2±3.0,高于恶性组的（20±9）u/L和1.7±1.0,差异均有统计学意义（P〈0.01）;结核组和恶性组血清腺苷脱氨酶活性分别为（15±6）u/L和（12±5）u/L,差异无统计学意义（P〉0.05）。应用ROC曲线确定胸腔积液腺苷脱氨酶诊断结核性胸膜炎的最佳临界值为30.7 u/L,灵敏度为70.5%,特异度为92.2%。结论：胸腔积液腺苷脱氨酶活性可作为鉴别结核性和恶性胸腔积液的重要指标,对结核性胸膜炎有较高的临床诊断价值,而血清腺苷脱氨酶活性对鉴别二者无临床意义。
Objective To investigate the clinical value of pleural effusion adenosine deaminase activity to differentiating tuberculous pleural effusion from malignant effusion.Methods A total of 80 inpatients with pleural effusion received thoracoscopy and biopsy of pleura and were diagnosed tuberculous pleuritis（42 cases） and malignant pleural effusion（38 cases）.The pleural effusion and adenosine deaminase activity were detected in these two groups.The optimal cutoff for tuberculous pleural effusion was determined with the ROC curve.Results The pleural effusion adenosine deaminase activity and the ratio of pleural fluid to serum adenosine deaminase were（48±25）u/L and 4.2±3.0 in tuberculous pleural effusion patients,significantly higher than those in malignant pleural effusion patients（20±9）u/L and 1.7±1.0 respectively（P0.01）.The serum adenosine deaminase activities were（15±6）u/L and（12±5）u/L in tuberculous pleuritis patients and malignant pleural effusion,which showed no significant difference（P0.05）.The cutoff value of pleural adenosine deaminase determined with ROC curve was 30.7 u/L,the sensitivity was 70.5% and the specificity was 92.2%.Conclusion The pleural effusion adenosine deaminase activity but not the serum adenosine deaminase activity can be used to differentiate tuberculous from malignant pleural effusion.
出处
《中华实用诊断与治疗杂志》
2011年第1期35-37,共3页
Journal of Chinese Practical Diagnosis and Therapy
关键词
结核
腺苷脱氨酶
胸腔积液
ROC曲线
Tuberculosis
adenosine deaminase
pleural effusion
ROC curve
作者简介
唐学义（1965年～），男，硕士，副主任医师，研究方向：呼吸系统疾病诊断与治疗。
