腹水ADA、TC及LDH水平对结核性腹水及恶性腹水的诊断价值

Diagnostic value of ADA,TC and LDH levels in tuberculous ascites and malignant ascites

目的探讨腹水中腺苷脱氨酶(ADA)、TC及乳酸脱氢酶(LDH)诊断结核性腹水及恶性腹水的应用价值。方法检测结核性腹水组(21例)、非结核性良性腹水组(46例)和恶性腹水组(44例)患者腹水中ADA、TC及LDH水平,绘制ROC曲线,分析相关指标对结核性腹水及恶性腹水的诊断价值。结果结核性腹水组ADA水平高于非结核性腹水组(恶性腹水组+非结核性良性腹水组)(51.50 U/L vs.6.05 U/L)(P<0.01)。结核性腹水组和恶性腹水组腹水TC水平为(2.54±0.80)mmol/L和(2.47±0.76)mmol/L,LDH水平为243.00 U/L和215.00 U/L,均高于非结核性良性腹水组的(0.76±0.55)mmol/L和57.00 U/L(P<0.05)。当腹水ADA水平为30.05 U/L时,其对结核性腹水的诊断灵敏度为95.2%,特异度为96.7%;当腹水TC水平为1.25 mmol/L时,其对结核性或恶性腹水的诊断灵敏度为96.9%,特异度为89.1%;当腹水LDH水平为103.5 U/L时,其对结核性或恶性腹水的诊断灵敏度为93.8%,特异度为89.1%。结论腹水ADA对结核性腹水有特异性诊断价值,腹水TC及LDH对结核性腹水及恶性腹水有诊断价值。

Objective To explore the diagnostic value of adenosine deaminase(ADA),total cholesterol(TC)and lactate dehydrogenase(LDH)levels in tuberculous ascites and malignant ascites.Methods The levels of ADA,TC and LDH in the ascites of 21 patients with tuberculous ascites(group A),44 patients with malignant ascites(group B)and 46 patients with non-tuberculous benign ascites(group C)were detected.ROC curve was drawn to analyze the value of ADA,TC and LDH in the diagnosis of tuberculous ascites and malignant ascites.Results ADA level in group A was higher than that in non-tuberculous ascites group(group B+group C)[51.50 U/L vs.6.05 U/L](P<0.01).Compated to group C,group A and group B had higher levels of TC[(2.54±0.80)mmol/L and(2.47±0.76)mmol/L vs.(0.76±0.55)mmol/L]and LDH[243.00 U/L and 215.00 U/L vs.57.00 U/L](P<0.05).Taking 30.05 U/L as the cut-off value,the sensitivity and specificity of ADA in the diagnosis of tuberculous ascites were 95.2%and 96.7%.Taking 1.25 mmol/L as the cut-off value,the sensitivity and specificity of TC in the diagnosis of tuberculous ascites were 96.9%and 89.1%.Taking 103.5 U/L as the cut-off value,the sensitivity and specificity of LDH in the diagnosis of tuberculous ascites were 93.8%and 89.1%.Conclusion ADA level of ascites has a specific diagnostic value for tuberculous ascites,but TC and LDH levels of ascites have the diagnostic value for tuberculous ascites and malignant ascites.