胸水ADA、TB-DNA联合检测对结核性胸膜炎的诊断价值

目的探讨结核性胸膜炎患者的胸水腺苷脱氨酶(ADA)、TB-DNA检测、以及ADA、TB-DNA联合检测对结核性胸膜炎的诊断价值。方法采用临床流行病学诊断试验的方法,检测87例疑为结核性胸膜炎患者胸水ADA、TB-DNA,ADA用酶法连续监测法,TB-DNA采用PCR方法用金标准将患者分为患病组和对照组,计算敏感性、特异性和准确性。结果胸水ADA对结核性胸膜炎的诊断敏感性、特异性和准确性分别为87.7%,90%,85.5%,TB-DNA对结核性胸膜炎的诊断敏感性、特异性、准确性分别为70.2%,83.3%,74.7%,ADA和TB-DNA联合检测的诊断敏感性、特异性和准确性分别为93.0%,93.3%,93.1%。结论采用酶法连续监测法检测胸水ADA可大幅度提高诊断价值,敏感性、特异性都比以往报道有所提高,如果联合TB-ADA检测更加提高了诊断的敏感性,特异性和准确性,并且基本满足临床需要,不必做过多的检测,以减轻病人负担。

Significance of Pleural Effusion Examination of ADA and TB-DNA for Diagnosis of Tuberculous Pleuritis

Objective To check the significance of pleural effusion examination of ADA and TB-DNA for diagnosis of tuberculous pleuritis.Methods Pleural effusion of 87 patients suspected of tuberculous pleural were examination about ADA and TB-DNA.ADA were examination with continuous monitored enzymatic method,and TB-DNA with PCR method.Results The sensitivity,specificity and accuracy of pleural effusion of ADA were 87.7%,90%,88.5%,respectively,those indces for examination of TB-DNA were 70.2%,83.3%,74.7%,respectively,Meanwhile for examination of both ADA and TB-DNA,they were 93.0%,93.3%,93.1%.Conclusion combined examination of both ADA and TB-DNA can increase the sensitivity,specificity and accuracy of diagnosis.