腺苷脱氨酶在部分神经系统疾病诊断中的作用

The Clinical Value of Adenosine Deaminase Level for the Diagnosis of Some Neurologic Diseases

目的检测血清和脑脊液中腺苷脱氨酶(ADA)含量的变化,探讨ADA辅助部分神经系统疾病临床诊断的意义。方法以过氧化物酶法检测201例良、恶性肿瘤、多发性硬化症、脑梗塞、脑积水、动脉血管瘤、病毒性脑膜炎、脑出血、脊髓瘤等9组不同神经系统疾病患者和24例非神经系统疾病患者血清和脑脊液中ADA水平,并用t检验或秩和检验方法将对照组和9组不同神经系统疾病患者的检测结果进行统计分析。结果对照组与神经系统不同疾病组血清ADA比较,差异均无统计学意义(P均>0.05);神经系统疾病各组之间比较,差异亦无统计学意义(P均>0.05)。除脑梗死组外,其他各组脑脊液ADA含量与对照组比较,差异有统计学意义(P均<0.01)。不同神经系统疾病各组之间脑脊液ADA含量比较,颅内恶性肿瘤组ADA水平明显高于良性肿瘤组,差异有统计学意义(P=0.037);多发性硬化症组与脊髓瘤、脑膜炎和脑出血组比较,差异均有统计学意义(P<0.05)。结论血清ADA检测对于部分神经系统疾病无诊断价值。脑脊液中ADA含量检测可以辅助颅内良、恶性肿瘤、脑积水、多发性硬化症、脊索瘤、脑膜炎和脑出血等部分神经系统疾病的鉴别诊断,但不是诊断的特异性指标。

Objective To study the clinical value of Adenosine deaminase in cerebrospinal fluid and serum for the diagnosis of some neurogieal diseases. Methods With Peroxidase assay to detect the Adenosine deaminase level in serum and eerebrospinal fluid in 201 eases of the neurological diseases（ benign tumors, malignant cancer, multiple sclerosis, cerebral infarction, hydrocephaly, eneephalie angiona, brain bemorrhage, spinal cord tumor, virus meningitis） as well as 24 normal persons. With t test or rank test to statistical analysis for the cases with neurological diseases which were divided into 9 groups and normal group. The eases of all neurological diseases groups were compared with each other. Results There was no significance for all the cases with adenosine deaminase level in serum from the neural disease. The adenosine deaminase levels in CSF from neurological diseases exception block in brain were significantly higher than those in normal group （ P 〈 0.01 ）. There were statistic significances. Adenosine deaminase levels in CSF from malignant cancer group were higher than those in benign tumors group （ P = 0.037 ）. Adenosine deaminase levels in CSF from multiple sclerosis were of statistic significances than those in spinal cord tumor, meningitis and cerebral hemorrhage （ P 〈 0. 05 ）. Conclusion Adenosine deaminase level in serum is of no significance in the diagnosis and identification. The determination of adenosine deaminase in cerebrospinal fluid is helpful in the diagnosis differentiation of some neurological diseases, but it is of no special significance in diagnosis.