TB-Ab和ADA联合检测在结核性胸腔积液104例中的诊断价值

Differentiation diagnostic value of TB-Ab and ADA measurement in Tuberculous Exudates

目的:探讨结核抗体(TB-Ab)和腺苷脱氨酶(ADA)在胸腔积液中的鉴别诊断价值。方法:应用斑点金免疫渗滤试验(DIG-FA)分别检测胸腔积液和血清中的TB-Ab;应用腺苷脱氨酶偶联谷氨酸脱氢酶连续检测法测定胸水及血清中的ADA活性,并运用统计学方法对数据进行处理。结果:结核性胸腔积液患者胸水和血清中TB-Ab的阳性率分别为65.3%和72.1%,与恶性胸腔积液患者TB-Ab的阳性率(11.3%和13.2%)相比有显著性差异(P<0.01);结核性胸腔积液ADA活性明显增高(64.37±22.41)与恶性胸腔积液ADA活性(16.23±6.26)相比有显著性差异(P<0.01);两者血清ADA活性无显著性差异(P>0.05)。结核组ADA胸水/血清>1(4.23±2.98),非结核组胸水/血清<1(0.69±0.22),两组相比有显著性差异(P<0.01)。结论:TB-Ab和ADA联合检测在结核性胸腔积液的诊断中具有重要的价值。

Objective： To evaluate the differential diagnosis value of measurement of Mycobacterium tuberculosis antibody （ TB - Ab） and adenosine deaminase （ADA） in tuberculous exudates. Methods ： The TB - Ab in pleural effusion and serum were measured by DIGFA, ADA were examined by method of continuous monitoring with enzyme. Results： The positive rates of TB -Ab in pleural effusion and in serum of 104 cases with tuberculosis were 65.3% and 72.1% respectively, which of 53 malignant exudates were 11.3% and 13.2% respectively. The ADA activity of tuberculosis and malignant exudates were respectively （64.37 ± 22.41 ） U/L and （16.23 ± 6.26）U/L . The p- ADA/s- ADA of tuberculosis and malignant exudates were respectively （4.23 ± 2.98 ） and （0.69 ± 0.22 ）. Conclusions ： The measurement of TB - Ab and ADA in pleural exudates and serum is of great value in differentiating tuberculous exudates.