检测腺苷脱氨酶和血清结核抗体鉴别胸腔积液的价值探讨

The value of adenoxine deaminase and serum antibody against tuberculosis in the differentiation diagnosis of pleural effusion.

目的探讨胸液和血清的腺苷脱氨酶(ADA)以及血清结核抗体(TBAb)检测在胸腔积液鉴别诊断上的价值.方法对2001～2004年确诊的结核性胸腔积液51例、恶性胸腔积液34例,其它渗出液27例及漏出液12例患者的胸腔积液、血清进行ADA和TBAb检测,对结果进行统计学分析. 结果结核性胸腔积液组的胸液ADA值显著高于其它三组(P＜0.01),血清ADA值与其它组比较则无差异.血清TBAb阳性率高于其它三组(P＜0.05);恶性胸腔积液组血清ADA低于其它三组(P＜0.05);漏出液组胸液ADA值均＜35U/L. 结论ADA对结核性胸腔积液诊断的敏感性、特异性均高,有重要诊断价值.血清TBAb对结核性胸腔积液有一定的诊断价值.

Objective To investigate the roles of chest fluid adenosine deaminase （ADA）, serum adenosine deaminase and serum tubercnlosis antibody （TBAb）in the differential diagnosis of pleural effusion. Methods All the patients were made a diagnosis in the department of respiratory medicine of the second affiliated hospital of sun yat - sen aniversity between January, 2001 and December,2004 which including four groups（51 cases of tubercnlous pleural effusion,34 cases of malignant pleural effusion, 27 cases of exudate of the others and 12 cases of transudate）. All the patients accepted detection of three indexes mention above. Statistical analysis was made of the results. Results Value of chest fluid ADA in tuberculous pleural effusion group was significant higher than that of the other three groups （P 〈 0.01）; serum ADA shows no difference between the four groups .A higher positive rate of Serum TBAb is found in group of tubercnlous pleural effusion （P 〈 0.05）. Value of serum ADA in group of malignant pleural effusion is significant lower than that of the other three groups. All patients of transudate group show a value of chest fluid ADA of less than 35U/ L. Conclusion Detection of chest fluid ADA is highly sensitive and specific for the diagnosis of tuberculous pleural effusion so that it is a very importmant method for differential diagnosis. Detection of serum TBAb is also helpful for diagnosis of tuberculous pleural effusion in a certain degree.