腺苷脱氨酶活性对自身免疫性肝病的临床意义研究

Clinical Significance of Adenosine Deaminase Activity in Autoimmune Liver Disease

目的:探讨腺苷脱氨酶(ADA)在自身免疫性肝病患者血清中的变化及其临床意义。方法:利用酶法试剂盒检测自身免疫性肝病患者血清中的总ADA(t ADA)及其同工酶ADA1和ADA2的活性变化,利用受试者工作曲线(ROC)分析总ADA、ADA1及ADA2活性的诊断价值。利用Spearman相关性分析自身免疫性肝病患者各指标之间的相关性。结果:与对照组相比,t ADA和ADA2活性在自身免疫性肝病患者血清中均极显著升高(P<0.001),ADA1活性有一定程度升高(P=0.035)。不同自身免疫性肝病亚型患者之间的血清t ADA、ADA1及ADA2活性均无显著差异。ROC分析显示,血清t ADA和ADA2活性具有诊断价值,ADA1活性无诊断价值。t ADA活性截断值取13.5 U/L时,诊断特异性为93.3%,敏感性为81.2%。血清ADA2活性截断值取9.5 U/L时,诊断特异性为85.0%,敏感性为83.3%。而ADA1无显著的诊断价值,ADA活性与白蛋白球蛋白比值呈显著负相关(r=-0.41,P=0.004),与球蛋白水平具有一定程度的正相关(r=0.34,P=0.018),与ALT呈弱正相关(r=0.29,P=0.042),与其他指标的相关性均无统计学显著性。结论:血清t ADA及ADA2活性在自身免疫性肝病患者血清中显著升高,并且具有一定的诊断价值。

Objective: To investigate the changes and clinical significance of serum adenosine deaminase activity(ADA) in patients with autoimmune liver disease(AILD). Methods: The activities of total ADA(t ADA) and its isoenzymes ADA1 and ADA2 in serum of AILD patients were detected by enzyme assay. The diagnostic value of serum t ADA, ADA1 and ADA2 activities were analyzed by using receiver operating curve(ROC). Spearman correlation was used to analyze the correlation among indexes in AILD patients.Results: Compared with the control group, the activities of t ADA and ADA2 in serum of AILD patients were increased significantly(P<0.001), and the activity of ADA1 was increased to a certain extent(P=0.035). There were no significant differences in serum t ADA,ADA1 and ADA2 activities among patients with different AILD subtypes. ROC analysis showed that serum t ADA and ADA2 activities had diagnostic value. When the t ADA activity cut-off value was 13.5 U/L, the diagnostic specificity and sensitivity were 93.3% and81.2% respectively. When the cut-off value of serum ADA2 activity was 9.5 U/L, the diagnostic specificity and sensitivity were 85.0%and 83.3% respectively. ADA1 has no significant diagnostic value. ADA activity was correlated negatively with albumin globulin ratio(r=-0.41, P=0.004), correlated positively with globulin level to a certain extent(r=0.34, P=0.018), correlated weakly with ALT(r=0.29,P=0.042), and had no statistical significance with other hepatic function indexes. Conclusion: Serum t ADA and ADA2 activities were increased significantly in AILD patients, and it could be a diagnostic biomarker for AILD.