胸水和血清ADA、TB-Ab-IgG联合检测对结核性胸膜炎的诊断探讨

目的 探讨胸水/血清腺苷脱氨酶(ADA)、结核抗体(TB-Ab-IgG)联合检测对结核性胸膜炎的诊断价值.方法 采用斑点金免疫渗滤试验(DIGFA)和酶连续监测法对234例胸腔积液进行胸水/血清ADA和TB-Ab-IgG检测结果进行分析.结果 结核性胸膜炎患者174例其胸水、血清中TB-Ab-IgG的阳性率分别为62.0%和70.1%,特异性分别为93.1%(56/60)和86.6%(52/60).ADA活性在结核性和癌性胸腔积液中分别为(59.58±29.85)U/L和(15.31±7.36)U/L(P<0.01).以P-ADA>40 U/L做为诊断结核的临界值,其敏感性为79.3%,特异性为86.4%;以P-ADA/S-ADA>1为临界值,其敏感性为97.7%,特异性为95.5%.结论 胸水和血清ADA、TB-Ab-IgG联合检测在结核性胸膜炎与非结核性胸膜炎上具有诊断与鉴别诊断价值.     

腺苷脱氨酶诊断结核性胸膜炎价值的再评价

目的 探讨胸腔积液和血清中腺苷脱氨酶(ADA)对鉴别结核性胸膜炎及恶性胸腔积液的临床价值.方法 回顾性分析91例经内科胸腔镜胸膜活检病理确诊为结核性胸腔积液(结核组49例)和恶性胸腔积液(恶性组42例)患者的胸腔积液及血清中ADA活性,应用受试者工作曲线(ROC曲线)确定结核性胸膜炎患者胸腔积液ADA的最佳临界值.结果 结核组胸腔积液ADA活性和胸腔积液ADA与血清ADA比值分别为(46±26)U/L和4.1±4.0,明显高于恶性组的(16±8)U/L和1.7±1.2,差异均有统计学意义(t值分别为7.383和3.852,均P＜0.01),结核组和恶性组的血清ADA活性分别为(13±5)U/L和(12±6)U/L,差异无统计学意义(t=1.582,P＞0.05).应用ROC曲线确定胸腔积液ADA诊断结核性胸膜炎的最佳临界值为28.7 U/L,灵敏度为75.5%,特异度为95.2%.结论 胸腔积液ADA活性可以作为鉴别结核性和恶性胸腔积液的重要指标,对结核性胸膜炎有较高的临床诊断价值,而血清ADA活性对鉴别两者无临床意义.     

白介素27和腺苷脱氢酶单独及联合检测对结核性胸膜炎诊断价值

目的 探讨白介素27((interleukin-27,IL-27)和腺苷脱氨酶(adenosine deaminase,ADA)单独检测及两者联合检测结果对结核性胸膜炎和恶性肿瘤所致胸腔积液的鉴别诊断价值。方法 选取2017年12月1日至2018年7月29日福建省福州肺科医院收治的胸腔积液患者101例,通过闭式胸膜活检、内科胸腔镜检查获得病理学证据或者痰/胸腔积液分枝杆菌培养阳性及菌种鉴定结果。根据诊断结果分为结核性胸膜炎患者61例(结核组);恶性肿瘤所致胸腔积液患者40例(恶性组),其中肺黏膜相关淋巴瘤1例,恶性胸膜间皮瘤1例,肺黏液表皮样癌1例,非霍奇金淋巴瘤1例,小细胞肺癌3例,肺腺癌33例。采用酶联免疫吸附法检测两组患者胸腔积液中的IL-27和ADA的含量并进行统计学分析。应用受试者工作曲线(ROC)确定IL-27和ADA检测结果对鉴别结核性胸膜炎与恶性肿瘤所致胸腔积液的最佳临界值,并进一步分析IL-27与ADA联合检测(串联试验、并联试验)对于诊断结核性胸膜炎的价值。结果 结核组患者胸腔积液中检测到的IL-27和ADA浓度分别为[409.48(229.04,954.97)]ng/L和(45.88±14.33)U/L,明显高于恶性组[分别为115.74(77.72,161.97)ng/L和10.50(7.00,15.00)U/L],差异均有统计学意义(Z=3.139,P<0.01;t=4.006,P<0.01)。绘制ROC曲线确定IL-27鉴别结核性胸腔积液与恶性胸腔积液诊断的最佳临界值为176.31ng/L,敏感度和特异度分别为85.25% (52/61)和82.50% (33/40);ADA鉴别结核性胸腔积液与恶性胸腔积液诊断的最佳临界值为28U/L,敏感度和特异度分别为93.44% (57/61)和87.50% (35/40)。串联试验方法联合检测,特异度(95.00%,38/40)较单独检测IL-27(82.50%,33/40)及单独检测ADA(87.50%,35/40)均明显升高,并有较好的敏感度(81.97%,50/61);并联试验方法联合检测,敏感度(96.72%,59/61)较单独检测IL-27(85.25%,52/61)及单独检测ADA(93.44%,57/61)均明显升高,但特异度较低(75.00%,30/40)。结论 胸腔积液中IL-27和ADA对结核性胸膜炎的诊断均有较高价值;IL-27和ADA串联试验有助于结核性和恶性肿瘤所致胸腔积液的鉴别诊断。     

ADA、IFN-γ在鉴别诊断结核性和恶性胸腔积液中的价值

目的探讨ADA(腺苷脱氨酶)、IFN-γ(γ-干扰素)在鉴别诊断结核性和恶性胸腔积液中的价值。方法对40例结核性胸腔积液患者(结核组),40例恶性胸腔积液患者(肿瘤组),分别在治疗前抽取适量胸腔积液,进行ADA活性、IFN-γ浓度测定。结果结核性胸腔积液中ADA活性、IFN-γ浓度显著高于恶性胸腔积液,差异具有显著性(P<0.01)。根据ROC(受试者工作特征)曲线评价ADA、INF-γ在鉴别诊断结核性胸腔积液和恶性胸腔积液中的价值,ADA、IFN-γ临界值分别为29.85U/L,151.77ng/L,其诊断结核性胸腔积液的敏感性分别为82.5%,92.5%,特异性为92.5%,95%,准确性为93.7%,98.5%。结论ADA、IFN-γ可作为诊断结核性胸腔积液的可靠指标,且IFN-γ具有更高的诊断能效。     

联合检测对结核性和恶性胸腔积液的鉴别诊断价值

目的探讨联合检测胸腔积液中腺苷脱氨酶(ADA)、C反应蛋白(CRP)、癌胚抗原(CEA)、乳酸脱氢酶(LDH)对结核性和恶性胸腔积液的诊断价值。方法以我院2012年1月至2012年12月112例住院的胸腔积液患者为研究对象,其中62例结核性胸腔积液患者,50例恶性胸腔积液患者,以酶比色法,免疫比浊法,速率法和电化学发光法检测上述患者胸腔积液中ADA、CRP、CEA和LDH浓度。结果结核性胸腔积液患者ADA和CRP的诊断敏感性显著高于恶性胸腔积液患者(P0.01),恶性胸腔积液患者CEA的诊断敏感性较结核性胸腔积液患者明显增高(P0.01)。以胸腔积液CEA7 ng/ml及LDH245 U/L为诊断标准,诊断恶性胸腔积液的敏感性,特异性分别为78.0%,80.6%;而以CEA7 ng/ml,LDH245 U/L及ADA40 U/L,CRP5 mg/L为诊断标准,诊断恶性胸腔积液的敏感性,特异性分别为94.0%,95.2%。以胸腔积液ADA40 U/L,CRP5 mg/L为诊断标准,诊断结核性胸腔积液的敏感性,特异性分别为82.3%,86.0%;而以CEA7 ng/ml,LDH245 U/L及ADA4 0U/L,CRP5 mg/L为诊断标准,诊断结核性胸腔积液的敏感性,特异性分别为96.8%,92.0%。结论联合检测胸腔积液中ADA、CRP、CEA、LDH的浓度可提高结核性和恶性胸腔积液鉴别诊断的敏感性和特异性。     

TB-Ab-IgG ADA和CEA对良恶性胸水鉴别诊断意义

目的　探讨胸水结核抗体 (TB-Ab-IgG)、腺苷脱氨酶 (ADA)、癌胚抗原 (CEA)联合检测对良恶性胸腔积液的鉴别价值。方法 采用DIGFA法、Giusti改良法和放射免疫法对 92例胸腔积液行胸水TB Ab IgG、ADA和CEA检测分析。 结果 TB Ab IgG在结核性、癌性和其它组胸腔积液中的阳性率分别是 81.8%、12 .8%和 1.1% ,特异性为 87.5 % ;ADA活性在结核性和癌性胸腔积液中分别为 (5 9.6± 2 8.8)U/L和 (2 4 .7± 11.5 )U/L(P <0 .0 1) ,CEA为 (8.5± 7.3)ng/mL和 (6 0 .2± 39.6 )ng/mL(P <0 .0 1) ,ADA在其它组胸腔积液中为 (44 .6± 2 6 .5 )U /L ,与结核性胸腔积液相比 (P >0 .0 5 )。结论 胸腔积液TB Ab IgG、ADA、CEA检测对良恶性胸腔积液有鉴别价值。     

血管内皮细胞生长因子C与腺苷脱氨酶联合检测在胸腔积液鉴别诊断中的意义

目的 了解血管内皮细胞生长因子C(VEGF-C)及腺苷脱氨酶(ADA)在不同原因胸腔积液中的表达,并探讨通过比值构建联合诊断对胸腔积液鉴别诊断的作用.方法 选择143例临床确诊的胸腔积液患者(恶性胸腔积液40例,结核性胸膜炎45例,其他类型58例),采用双抗夹心ELISA法检测胸水VEGF-C,采用速率法检测胸水ADA,计算VEGF-C/ADA比值,比较不同类型胸腔积液患者中上述诊断指标的变化,并计算它们的敏感度、特异度和准确度.结果 恶性胸腔积液中VEGF-C浓度高于结核性胸腔积液及类肺炎性等其他类型胸腔积液,(286.32±102.65)ng/L vs(133.46±39.83)ng/L,(140.14±44.62)ng/L,P<0.05.结核性胸腔积液中ADA浓度高于恶性胸腔积液及其他类型胸腔积液,(78.6±36.3)IU/L vs(23.4±11.2)IU/L,(26.1±10.5)IU/L,P<0.05.VEGF-C/ADA≥8对恶性胸腔积液诊断的敏感度为87.5%,特异度为81.4%;VEGF-C/ADA≤3对结核性胸腔积液诊断的敏感度为84.4%,特异度为86.4%.结论 VEGF-C与ADA浓度比值对胸腔积液的鉴别诊断具有较好的临床价值.     

胸液蛋白电泳及腺苷脱氨酶在结核性与恶性胸腔积液鉴别诊断中的应用

目的对结核性及恶性胸腔积液患者的胸液蛋白电泳进行分析及ADA检测,探讨二者在结核性胸腔积液与恶性胸腔积液诊断中的应用价值。方法对36例结核性胸腔积液患者及38例恶性胸腔积液患者的胸液标本行琼脂糖凝胶蛋白电泳并应用比色法检测腺苷脱氨酶(ADA)浓度。结果结核性胸腔积液组与恶性胸腔积液组的胸液α₁球蛋白分别为4.32±1.35和3.41±0.97(P＜0.05),α₂球蛋白分别为8.98±1.50和6.01±1.53(P＜0.000),α₂球蛋白/白蛋白的比值分别为0.15±0.03和0.09±0.03(P＜0.000),ADA分别为71.35±24.00和31.21±11.90(P＜0.000)。根据ROC曲线结果判断分别取0.13及45为界值,计算α₂球蛋白/白蛋白对诊断结核性胸腔积液的敏感性、特异性及准确性分别为76%、89%、83%;ADA的敏感性、特异性及准确性分别为82%、78%、80%。采用平行试验方法,联合α₂球蛋白/白蛋白和ADA指标,其敏感性、特异性和准确性分别达到88%,100%和94%。结论(1)结核性胸腔积液患者的胸液α₁球蛋白、α₂球蛋白、α₂球蛋白/白蛋白的比值及ADA均高于肿瘤组,差异有显著性(P＜0.05)。(2)联合检测α₂球蛋白/白蛋白和ADA可以提高结核性胸腔积液诊断的敏感性、特异性和准确性。     

胸水ADA、TB-DNA联合检测在结核性胸膜炎中的诊断运用

目的分析胸水ADA、TB-DNA联合检测对结核性胸膜炎诊断运用价值。方法对我院收治的结核性胸膜炎患者183例、癌性胸水患者65例以及炎性胸水患者49例作为研究对象,分别进行ADA、TB-DNA的检测,并对ADA、TB-DNA在三种疾病中的阳性率以及对结核性胸膜炎的敏感度、特异性以及准确性进行分析。结果结核性胸膜炎患者的ADA含量(72.3±23.2 IU/L)明显高于炎性胸水患者(38.4±12.9 IU/L)以及癌性胸水患者(24.3±6.5 IU/L);ADA、TB-DNA联合检测对结核性胸膜炎的特异性84.2%,敏感性98.91%以及准确性为93.26%。结论对结核性胸膜炎患者采用胸水ADA、TB-DNA联合检测可明显提高其检出率,并有助于对结核性胸膜炎胸水、癌性胸水以及炎性胸水的鉴别。     

DNA实时荧光恒温扩增法联合检测对结核性胸膜炎的早期诊断价值

目的:分析DNA实时荧光恒温扩增法(简称“恒温扩增法”)联合腺苷脱氨酶(adenosine deaminase, ADA)、外周血结核感染T细胞斑点试验(T-SPOT.TB)检测对结核性胸膜炎患者早期诊断的价值。方法:采用回顾性研究方法,选取2020年1月至2021年12月西安市胸科医院收治的不明原因胸腔积液患者427例作为研究对象。所有研究对象均进行胸腔积液恒温扩增法、胸腔积液ADA、胸腔积液结核分枝杆菌培养和外周血T-SPOT.TB检测。以临床综合诊断作为参考标准,评价恒温扩增法联合ADA、外周血T-SPOT.TB对结核性胸膜炎的早期诊断价值。结果:427例研究对象中,279例(65.3%)确诊为结核性胸膜炎(结核性胸膜炎组),148例确诊为非结核性胸膜炎(非结核性胸膜炎组)。ADA的最佳诊断界值为19.5 U/L。单一检测方法中,恒温扩增法的特异度为100.00%,敏感度为31.54%,与结核分枝杆菌培养类似(分别为100.00%和30.11%)。胸腔积液ADA和外周血T-SPOT.TB检测的敏感度分别为74.91%和84.95%,特异度分别为87.16%和74.91%。ADA+...     

联合测定分泌型白细胞蛋白酶抑制因子和腺苷脱氨酶在结核性胸腔积液中的诊断意义

目的探讨联合测定胸腔积液中分泌型白细胞蛋白酶抑制因子（SLPI）和腺苷脱氨酶（ADA）浓度对结核性胸腔积液的诊断价值。方法收集103例胸腔积液及其同源外周血,其中结核性胸腔积液组为45例,恶性胸腔积液组31例,细菌性胸腔积液组16例,漏出液组11例。应用ELISA法测定胸水上清液和血清中SLPI的浓度,用比色法测定ADA水平,并对结果及意义进行分析。结果 （1）结核组SLPI浓度（193790±15476）pg/ml,与恶性组（121700±13101）pg/ml、细菌组（92885±26962）pg/ml、漏出液组（109360±21619）pg/ml相比差异均有统计学意义（P〈0.05）;恶性组、细菌组及漏出液组间相比差异均无统计学意义（P〉0.05）。结核组及细菌组ADA水平与恶性组及漏出液组比较差异有统计学意义（P〈0.05）。（2）受试者工作特征曲线（ROC曲线）结果显示,胸腔积液SLPI浓度对于诊断结核性胸腔积液的最佳阈值为236071pg/ml,曲线下面积（AUC）为69.9%（95%可信区间为58.2%～81.6%）,灵敏度和特异度分别为43.2%和91.4%（P〈0.05）;ADA对于诊断结核性胸腔积液的曲线下面积、灵敏度、特异度、诊断阈值分别是71.9%（可信区间60.9%～82.8%）、75%、64.2%和29.5（P〈0.001）;SLPI和ADA同时高于各自的诊断阈值,得出最佳诊断特异度为95%;SLPI或ADA高于诊断阈值,得出最佳诊断灵敏度为89%。结论单独测定SLPI及ADA均有助于诊断结核性胸腔积液,但联合测定更能提高诊断效能。     

Diagnostic utility of adenosine deaminase (ADA) activity in pleural fluid and serum of tuberculous and non-tuberculous respiratory disease patients

Adenosine deaminase activity (ADA) was assayed in pleural fluid and serum of 42 subjects with pleural effusion. Twenty-nine of them had TB pleural effusion and the remaining 13 had pleural effusion due to non-TB respiratory diseases. Serum adenosine deaminase activity were also measured in 32 pulmonary tuberculosis patients without pleural effusion and equal numbers of healthy controls without systemic diseases for comparative analysis. The patients attending the medicine out-patient department (MOPD) of the B. P. Koirala Institute of Health Sciences, Dharan, Nepal were taken as study subjects. Serum and pleural fluid ADA activities were assayed spectrophotometrically by the method of Guisti and Gallanti. The mean serum ADA activity was significantly increased in patients with tubercular pleural effusion (34.53 +/- 10.27 IU/l) compared to pulmonary tuberculosis patients without pleural effusion (26.54 +/- 4.76 IU/l), (p = 0.004), those with non-TB respiratory disease (16.71 +/- 5.16 IU/l), (p = 0.0001) and healthy controls (15.53 +/- 4.4 IU/l) (p = 0.0001). The mean ADA in the pleural fluid of tubercular pleural effusion patients (90.29 +/- 54.80 IU/l) was significantly higher compared to those with non-TB respiratory disease (24.43 +/- 9.28 IU/l) (p = 0.0001). Using the lowest cutoff value for enzyme activity in the serum of patients with TB pleural effusion (25 IU/l), a test sensitivity of 72.41% and specificity of 81.53% were obtained. Using the lowest cutoff value for enzyme activity in pleural fluid of patients with TB pleural effusion (45 IU/l) the sensitivity and specificity for diagnosis were 76.10% and 100%, respectively. Therefore, the measurement of ADA in tubercular pleural effusion has a utility in the diagnosis of tuberculosis when other clinical and laboratory tests are negative.     

A prospective study of sensitivity and specificity of adenosine deaminase estimation in the diagnosis of tuberculosis pleural effusion

We prospectively evaluated the usefulness of adenosine deaminase [ADA] estimation in the diagnosis of tuberculosis [TB] pleural effusion. Seventy five subjects with pleural effusion were studied. Forty eight of them had TB pleural effusion [M:F: 37:11; mean age 33 +/- 14.4 years range 17-76] and the remaining 27 had pleural effusion due to causes other than TB [non-TB group] [M:F: 19:8; mean age 47.3 +/- 16.5 years; range 17-75]. Pleural fluid [PF] ADA levels were significantly higher in TB (n=48; mean 95.8 +/- 57.5 IU/L) compared with non-TB group (n=27; mean 30.7 +/- 27.2 IU/L) [p<0.001]. Serum ADA [S-ADA] levels were also significantly higher in TB (n=45; mean 39.6 +/- 18.3 IU/L) compared with non-TB group (n=26; mean 18.0 +/- 13.7 IU/L) [p<0.001]. PF-ADA levels were higher compared to S-SDA in TB (p <0.001) and non-TB groups [p<0.01]. Using a cut off of 35 IU/L, the sensitivity and specificity of PF-ADA in the diagnosis of TB was computed to be 83.3% and 66.6% respectively. At a cut-off level of 100 IU/L, PF-ADA was found to have a sensitivity 40% and specificity 100%. From this study it is concluded that, using 100 IU/L as the cut-off, it is possible to avoid pleural biopsy to ascertain the diagnosis of TB in as much as 40% of the patients.     

ADA、IFN-γ及结核分枝杆菌抗体联合检测对结核性胸膜炎的诊断价值

目的探讨ADA活性、IFN-γ含量和结核分枝杆菌抗体联合检测对结核性胸膜炎的诊断价值。方法检测56例已经经组织病理学或病原学明确诊断的结核性胸膜炎患者,20例经细胞学或组织病理学明确诊断的恶性胸腔积液患者,以及12例其他渗出性胸腔积液患者的胸液和血清中的ADA活性和IFN-γ含量以及抗结核分枝杆菌抗体阳性率,经统计学处理后,评价各项指标对结核性胸膜炎诊断的灵敏度、特异度及临床诊断符合率。结果结核性胸液中ADA活性、IFN-γ含量分别为（50.98±13.07）U/L、（139.46±70.43）pg/ml,结核分枝杆菌抗体阳性率60.7%,与恶性胸液组和其他组比较差别有统计学意义,P<0.05。以45U/L为临界值,ADA对结核性胸膜炎诊断的灵敏度为80.4%,特异度96.9%,临床诊断符合率为86.4%;IFN-γ以100pg/ml为临界值对结核性胸膜炎诊断的灵敏度为83.9%,特异度93.8%,临床诊断符合率为87.5%;胸液中结核分枝杆菌抗体检测对结核性胸膜炎诊断的灵敏度为 60.7%,特异度为87.5%,临床诊断符合率为70.5%。以3项指标联合检测任何2项阳性对结核性胸膜炎诊断的灵敏度为 92.9%,特异度100%,临床诊断符合率为95.5%。结论ADA活性、IFN-γ含量和结核分枝杆菌抗体联合检测可极大地提高结核性胸膜炎的诊断效能。     

ADA、IFNγ-、sIL-2R检测在鉴别结核性和癌性胸水中的价值

目的研究腺苷脱氨酶（ADA）、γ干扰素（IFN-γ）、可溶性白介素2受体（sIL-2R）对结核性胸水和癌性胸水鉴别诊断的价值。方法采用酶法和ELISA方法检测47例结核性胸水患者和47例癌性胸水患者胸水中ADA活性和IFNγ-、sIL-2R水平。结果结核性胸水组的ADA（72.3±21.7 U/L）、IFN-γ（481.3±257.1 pg/m l）和sIL-2R（611.0±184.4 pmol/L）都显著高于癌性胸水组（P〈0.01）;当以ADA≥46.8 U/L、IFNγ-≥209.0 pg/m l和sIL-2R≥491.5 pmol/L为临界值,三项指标对结核性胸水的敏感度分别为93.6%,87.2%,70.2%;特异度分别为91.5%,91.5%,78.7%。结论胸水中ADA、IFN-γ和sIL-2R对结核性胸水和癌性胸水的鉴别诊断都有较高的临床价值。     

Age : pleural fluid ADA ratio and other indicators for differentiating between tubercular and malignant pleural effusions

Most of pleural effusions are caused by tuberculosis and malignant tumor. Difficult sampling and bacterial sparing nature of these diseases challenge doctors’ diagnosis in China.This study aimed to develop a new convenient and effective method for the differentiation of tuberculous and malignant pleural effusion.A prospective cohort study of patients hospitalized with malignant (n = 90) and tuberculous (n = 130) pleural effusions from September 2018 to October 2020 was performed. The diagnostic performance of the age to pleural fluid ADA ratio (age/ADA) and other indicators to distinguish tuberculous and malignant pleural effusions was evaluated by receiver operating characteristic (ROC) curve analysis.The areas under the curve (AUC) of age/ADA and pleural fluid ADA were largest. Age/ADA showed sensitivity and specificity of 81.5% (95%CI 73.8%–87.8%) and 97.8% (95%CI 92.2%–99.7%) respectively. The sensitivity and specificity of pleural fluid ADA were 83.1% (95%CI 75.5%–89.1%) and 93.3% (95%CI 86.1%–97.5%) respectively. The positive likelihood [36.69 (95%CI 9.3–144.8)] of age/ADA was significantly higher than that of pleural fluid ADA [12.46 (95%CI 5.7–27.1)]. The AUCs for Cancer Ratio and Cancer Ratio plus were lower and showed a sensitivity of 80.0% (95%CI 72.1%–86.5%), 80.0% (95%CI 70.2%–87.7%) and a specificity of 81.5% (95%CI 73.8%–87.8%), 80.0% (95%CI 70.2%–87.7%) respectively.Age/ADA has a higher diagnostic accuracy than ADA. Age/ADA is a promising diagnostic index for tuberculous and malignant pleural effusion with high sensitivity and specificity, especially the high positive likelihood ratio. The diagnostic accuracy of Cancer Ratio and Cancer Ratio plus are inferior to those of age/ADA and ADA.     

Diagnostic significance of gamma-interferon in tuberculous pleurisy

We studied ADA and gamma interferon (gamma-IFN) levels in pleural fluid of 45 cases presenting with pleural effusion to the Ankara University School of Medicine Chest Diseases Hospital between September 2001 and September 2002. Fifteen patients had TB pleurisy, 20 patients had malignant pleurisy and 10 patients had transudative pleural effusion. The cut-off value for pleural fluid gamma-IFN levels were 12 pg/mL. According to this, all patients with transudative effusions, 19 of 10 patients with malignant effusions and 2 of 15 patients with tuberculous (TB) effusions had pleural fluid gamma-IFN levels under the cut-off value. In exudative effusions, sensitivity and specificity of gamma-IFN were 87% and 95% respectively. The sensitivity of pleural fluid ADA levels was 86% and specificity of pleural fluid ADA levels was 100%. Pleural fluid ADA levels in TB effusions were significantly higher than the non-TB effusions. Also there were no statistically significant differences between pleural fluid ADA and g-IFN levels according to sensitivity and specificity. As a result, we have shown that gamma-IFN is a valuable test in diagnosis of TB pleurisy. We think that when it is used routinely, it will be a good alternative to the conventional invasive diagnostic tests.     

TB-SA结核分枝杆菌抗体检测对结核性胸膜炎的诊断意义

目的评估胸水和血清特异性TB—sA结核抗体对结核性胸膜炎的诊断价值。方法用TB—sA抗体IgG检测试剂盒（酶联免疫法）分别检测121例结核性胸膜炎和30例非结核性胸膜炎胸水、血清标本中的TB—SA结核抗体,分析实验资料。结果121例结核性胸膜炎组中,胸水检测TB-sA抗体的敏感性为68．60％,血清检测TB—sA抗体的敏感性为33．88％。30例非结核性胸膜炎组胸水检测的特异性为96．67％,血清检测特异性为96．67％。结论胸水TB-SA抗体检测在结核性胸膜炎的诊断和鉴别诊断中具有较重要的参考价值。