胸腔积液ADA、LZM、LAM-IgG联合检测对结核性胸腔积液鉴别诊断的意义

Diagnostic Value of Adenosine Deaminase, Lyzozyme and Anti-Lipoarabinomannan Antibody for Tuberculous Pleural Effusions

目的 :探讨胸腔积液腺苷脱氨酶 (ADA)、溶菌酶 (LZM )、阿拉伯糖甘露糖脂抗体 (LAM IgG)联合检测在结核性胸腔积液鉴别诊断中的意义。方法 :以氨试剂法、MTS比色法和金标法同时检测了 4 1例结核性胸腔积液、2 3例癌性胸腔积液和 18例非结核性炎性胸腔积液的ADA、LZM和LAM IgG。 结果 :结核性胸腔积液ADA、LZM活性明显高于癌性胸腔积液和非结核性炎性胸腔积液 (P <0 .0 1) ;LAM IgG单项阳性的敏感性为 87% ,特异性为 81% ,3项联合检测的敏感性为 98.7% ,特异性为 10 0 %。结论 :ADA、LZM、LAM IgG联合检测可为结核性胸腔积液的鉴别诊断提供可靠依据。

Objective:To explore diagnostic value of adenosine deaminase(ADA)? Lyzozyme (LZM) and anti-lipoarabinomannan antibody (LAM-IgG) for tuberculous pleural effusions. Methods:ADA?LZM?LAM-IgG were detected using colormetric assay and dot immunogold filtration assay in 84 pleural effusions with tuberculosis, carcinoma or non-tuberculosis infection. Results: ADA?LZM?LAM-IgG activity in tuberculous pleural effusions were higher than others significantly (P<0.01).Sensitivity and specifity of single LAM-IgG positive for diagnosing tuberculous pleural effusions were 81% and 87%, respectively. And sensitivity and specifity of ADA?LZM?LAM-IgG combination were 98.7% and 100%. Conclusion: ADA?LZM?LAM-IgG are useful parameters for diagnosis of tuberculous pleural effusions.