不同类型标本腺苷脱氨酶对结核病诊断界点确定

目的探讨血清、胸腹腔积液、脑脊液中腺苷脱氨酶(ADA)测定对结核性胸腹腔积液、结核性脑膜炎诊断及鉴别诊断的临床应用价值。并通过ROC曲线分别确定胸腹腔积液、脑脊液中ADA测定对结核具有最佳诊断价值的界点。方法测定实验组与对照组血清、胸腹腔积液、脑脊液中的ADA。结果胸腹腔积液、脑脊液、血清中ADA对结核病诊断的阳性率分别达到了94.1%,60%,71.2%,30%,明显高于两种传统方法(P<0.01)。通过ROC曲线确定出胸腹腔积液、脑脊液ADA测定对结核病具有最佳诊断价值的界点分别为20和14U/L。结论血清、胸腹腔积液、脑脊液中ADA测定对结核病具有较高临床应用价值,但不同标本类型具有不同诊断界点。

Confirming Diagnostic Limitation of Adenosine Deaminase in Different Types Sample for Tuberculosis

Objective To explore diagnostic value of adenosine deaminase(ADA) in serum,pleural fluid,spinal fluid for tuberculosis,tuberculous pleuritis and tuberculous meningitis.To confirm limitation with the best diagnostic value in pleural fluid,spinal fluid through ROC.Methods To measure the value of ADA of experimental group and control group in serum,pleural fluid and spinal fluid.Results The rate of positive of ADA in pleural fluid, spinal fluid and serum were 94.1%,60%,71.2% and 30% respectivetly in the diagnosis of tuberculosis which was significant higher than two traditional methods(P<0.01).The confirmed limitation with the best diagnostic value in pleural fluid and spinal fluid were 20U/L and 14U/L through ROC.Conclusion The measuration of ADA in serum,pleural fluid and spinal fluid has higher clinical value.The diagnostic limitation is different in different types sample.