腺苷脱氨酶在胸腔积液鉴别诊断中的作用

目的探讨腺苷脱氨酶(ADA)在胸腔积液鉴别诊断的价值。方法用G iusti比色法测定187例胸腔积液中胸水ADA水平。结果以ADA≥45U/L为阳性界值,阳性率结核性胸膜炎占80%(48/60例);漏出液占11.6%(5/43例);恶性肿瘤占19.7%(12/61例);肺炎、脓胸占28.6%(4/14例);经t检验结核性胸膜炎与非结核性胸腔积液ADA≥45U/L水平时有显著差异(P<0.01)。结论ADA在结核性胸腔积液中有应用价值,但需与PPD试验、结核中毒症状、血沉增快等因素综合考虑。

The role of ADA in differentiating diagnosis of pleural effusion

Objective To explore the value of ADA in differntiating diagnosis of pleural effusion.Methods Giusti's colorimetry was used to test the pleural ADA of plerural effusion patients.Results Based on predefined criteria of ADA >= 45U/L being positive,80% of the studied tuberculous effusion cases(48 out of 60) was positive;11.6% of transudaet cases(5/43) being positive;19.7% of malignant effusion(12/61) being positive;28.6% of pneumonia and empyema(4/14) being positve.There was no interstitial lung disease case being positive. 50% of other disease cases(2/4) was ADA positive.In the nontuberculous pleuritis cases,12.3% was positive.When ADA was above 45U/L,the P value of tuberculous pleuritis and nontuberculous pleuritis was below 0.01 in test.The overall sensitivity rate was 78.7% and specificity was 89.7%.Conclusion ADA value is of practical significance in tuberculous effusion.But in diagnosis,it is important to take into consideration other factors such as PPD test,symptoms of tuberculosis and accelerated ESR.