血清和胸水中的乳酸脱氢酶、腺苷脱氨酶水平及比值在结核性胸膜炎诊断中的价值

The value of serum and hydrothorax lactic dehydrogenase and adenosine deaminase and their ratio on diagnosis of tuberculosis pleurisy

目的分析血清和胸水中的乳酸脱氢酶(LDH)、腺苷脱氨酶(ADA)水平及其比值在结核性胸膜炎诊断中的价值。方法将50例结核性胸膜炎患者作为A组,50例恶性胸腔积液患者作为B组,50例其它类型良性胸腔积液患者作为C组。检测并比较结核性胸膜炎、恶性胸腔积液及其他类型良性胸腔积液组血清、胸水中的ADA和LDH及其比值的差异,分析各种指标单独应用及联合应用的检查效果。结果 A组胸水、血清中ADA水平及胸水ADA/血清ADA比值均显著高于B组及C组,差异具有统计学意义(P<0.05)。A组胸水LDH及胸水LDH/血清LDH比值明显低于B组,但明显高于C组,组间比较,差异具有统计学意义(P<0.05)。A组血清LDH显著高于B组及C组,差异具有统计学意义(P<0.05)。两种方法联合检验对结核性胸膜炎诊断准确率为96.0%,显著高于单一检查方法的81.3%和88.7%,也显著高于胸膜活检及胸水TB-PCR技术,差异具有统计学意义(P<0.05)。结论血清和胸水中的乳酸脱氢酶、腺苷脱氨酶联合检测能明显提高结核性胸膜炎诊断准确率,可在临床推广应用。

Objective To analyze the value of lactate dehydrogenase （LDH）, adenosine deaminase （ADA） levels in serum and pleural effusion and their ratio on diagnosis of tuberculosis pleurisy. Methods 50 tuberculosis pleurisy pa- tients were chosen as group A, 50 patients with malignant pleural effusion were chosen as group B and 50 patients with other benign pleural effusion were chosen as group C. ADA and LDH of pleural effusion and serum were observed. The effectiveness of the various indicators of the application and the joint application of the inspection were analyzed. Results The serum and pleural effusion ADA of group A were significantly higher than those in group B and group C. The differ- ence had statistically significant （P〈0.05）. The serum LDH and ratio of LDH and LDH in the group A was significant- ly lower than that in group B, But significantly higher than that in group C. The difference had statistically significant （P〈0.05）. The serum LDH in group A was significantly higher than that in group B and group C. The difference had statistically significant （P〈0.05）. The combination of the two methods to test the tuberculosis pleurisy diagnostic accu- racy rate was 96%, which was significantly higher than that of the single test method （81.3% and 88.7%）. The differ- ence was statistically significant （P〈0.05）. Conclusion Serum lactate dehydrogenase and adenosine deaminase com- bined detection can significantly improve the accuracy of the diagnosis of tuberculosis pleurisy.