腺苷脱氨酶及其同工酶、谷草转氨酶对艾滋病合并马尔内菲青霉菌病的早期诊断意义

Early diagnosis significance of adenosine deaminase isoenzymes and AST of AIDS-Penicillium Manefi Disease

目的探索特异性的指标,以早期筛查出马尔尼菲青霉菌病(PSM)。方法本研究纳入经确认的艾滋病患者158例,分为HIV感染组62例、AIDS患者组43例、PSM组53例,酶偶联速率法检测腺苷脱氨酶(tADA)及其同工酶ADA1和ADA2、AST水平,并分析相关性。结果PSM组的CD4+T细胞计数显著低于AIDS组和HIV感染组(p<0.05,p<0.05);PSM组的tADA活性明显高于其他组(P均<0.05),且PSM组的ADA2活性显著高于其他两组(P均<0.05),但各组ADA1活性无显著差异(P>0.05);PSM组的AST和ALT明显高于其他组(P均<0.05)。与治疗前比较,治疗后PSM组的tADA、ADA2和AST值降低(P均<0.01)。经ROC曲线分析,tADA、ADA2和AST的临界值分别为18.5、13.4和115.9U/L。结论tADA、ADA2和AST均有望成为早期筛查PSM的血清学指标,其中ADA2效果最好,其灵敏度和特异性均较高。

Objective To explore specific indicators for early screening of penicilliosis marneffei (PSM). Methods 158 confirmed AIDS patients, 62 HIV patients, 43 AIDS patients and 53 PSM patients were enrolled in this study. The levels of adenosine deaminase (tADA), isozymes ADA1 and ADA 2 and AST were detected by enzyme coupling rate method, and the correlation was analyzed. Results CD4 + T cell count in PSM group was significantly lower than that in AIDS infected group and HIV group ( P <0.05, P <0.05). The activity of tADA in PSM group was significantly higher than that in other groups ( P <0.05, P <0.05). And the activity of ADA2 in PSM group was significantly higher than that in other two groups ( P <0.05, P <0.05). But there were no statistical significantly differences in ADA1 activity among the groups ( P >0.05). The AST and ALTs in PSM group were significantly higher than those in other groups ( P <0.05, P <0.05). Compared with the data before treatment, the values of tADA, ADA2 and AST in PSM group decreased after treatment ( P <0.01). The critical values of tADA, ADA2 and AST were 18.5, 13.4 and 115.9 U/L by ROC curve analysis, respectively. Conclusion tADA, ADA2 and AST are expected to be serological indicators for early screening of PSM, among which ADA2 has the best effect, high sensitivity and specificity.