结核性胸膜炎胸腔积液腺苷脱氨酶活性与年龄的相关性研究

The correlation study of hydrothorax adenosine deaminase activity and age of patients with tuberculous pleuritis

目的 研究结核性胸膜炎胸腔积液腺苷脱氨酶（adenosine deaminase,ADA）活性与年龄的相关性,为临床诊断提供参考。方法 选取2008年3月1日至2013年3年31日本院诊治的结核性胸膜炎患者248例为研究对象,按年龄段分组,分别测定各组患者胸腔积液ADA活性,分析其与年龄的相关性。结果 20129岁、30-39岁、40-49岁、50-59岁、60-69岁、70-79岁、≥80岁组患者胸腔积液ADA活性分别为（64.0±18.4）、（62.0±19.0）、（59.0±17.6）、（50.0±14.5）、（52.8±14.0）、（39.1±12.0）、（41.9±32.8）U/L,年龄相差越大,胸腔积液ADA活性差别越大（F=24.381,P=0.000）;≥50岁以上组患者的胸腔积液ADA活性与20-29岁组相比均具有显著差异（P〈0.05）;年龄与胸腔积液ADA活性呈负相关（r=-0.942）;胸腔积液ADA活性〉45 U/L为诊断结核性胸膜炎的临界值,20-29岁、30-39岁、40-49岁、50159岁、60-69岁、70-79岁、≥80岁组的诊断灵敏度分别为91.59%、93.18%、90.63%、82.61%、66.67%、53.85和45.45%,组间差异显著（P〈0.05）。结论 结核性胸膜炎胸腔积液ADA活性与年龄呈负相关,年龄是ADA活性的影响因素之一,对不同年龄段的患者选取不同的ADA临界值来诊断结核胸膜炎可降低漏诊率和误诊率。

Objective To study the correlation between hydrothorax adenosine deaminase （ADA） activity and age of patients with tuberculous pleuritis, to provide reference for clinical diagnosis. Method 248 patients with tuberculous pleuritis in our hospital from March 1, 2008 to March 31, 2013 were chosed as the research objects. They were divided into groups according to the age. Hydrothorax ADA activity was determined. Its relativity with age was analyzed. Result Hydrothorax ADA activity in age group 20 - 29 years old, 30 - 39 years old, 40 - 49 years old, 50 - 59 years old, 60 - 69 years old, 70 - 79 years old, ≥ 80 years old were （64.0±18.4）, （62.0± 19.0）, （59.0±17.6）, （50.0± 14.5）, （52.8±14.0）, （39.1 ±12.0）, （41.9±32.8） U/L respectively. The larger the age difference, the greater the difference of ADA activity in pleural effusion （F = 24.381, P = 0.000）. The difference of hydrothorax ADA activity between /〉 50 years old patients and 20 - 29 years old patients were significant （P 〈 0.05）. It showed significant difference among these age groups by variance analysis. Age was negatively related with hydrothorax ADA activity （r = - 0.942）. Hydrothorax ADA activity 〉 45 U/L for the diagnosis of tuberculous pleuritis threshold, the diagnosis sensitivity of 20 - 29 years old, 30 - 39 years old, 40 - 49 years old, 50 - 59 years old, 60 - 69 years old, 70 - 79 years old,≥ 80 years old group were 91.59%, 93.18%, 90.63%, 93.18%, 66.67%, 53.85 and 45.45%, differences between those groups were statistically significant by chi-square test （P 〈 0.05）. Conclusion The hydrothorax ADA activity have negative correlated to the age in tuberculous pleuritis, the age is one of the factors affecting the ADA activity, different age patients choose different ADA critical value to diagnosis of tuberculous pleuritis can decrease the missed diagnosis and misdiagnosis rate.