胸腔积液ADA、CRP和LAM-IgG联合检测的鉴别诊断价值

目的探讨胸腔积液腺苷脱氨酶(ADA)、C反应蛋白(CRP)、阿拉伯糖甘露糖脂抗体(LAM-IgG)联合检测对良恶性胸腔积液鉴别诊断的意义。方法以氨试剂法、散射比浊法和金标渗滤法同时检测了48例结核性胸水、27例癌性胸水和31例非结核炎性胸水的ADA、CRP和LAM-IgG。结果结核性胸水ADA、CRP活性明显高于癌性胸水(P<0.01),其它炎性胸腔积液CRP含量明显高于结核性和恶性胸腔积液(P<0.01);以ADA>30u/L,CRP>8mg/L,及LAM-IgG阳性等单个指标来诊断结核性胸腔积液,其敏感性达到95.7%,特异性为98.1%;以ADA<30u/L,CRP<8mg/L,及LAM-IgG阴性等单个指标来诊断恶性胸腔积液,其敏感性达到98.7%,特异性为97.1%。结论ADA、CRP、LAM-IgG联合检测可为良恶性胸腔积液的鉴别诊断提供可靠的实验室依据。

Differential Diagnosis Value of Adenosine Deaminase,C-reactive Protein and Anti-Lipoarabinomannan Antibody for Pleural Effusions

Objective To explore differential diagnosis va lu e of adenosine deaminase(ADA),C-reactive protein(CRP)and anti-lipoarabinomanna n antibody (LAM-IgG)for pleural effusions.Methods ADA,CR P and LAM-IgG were detected using colormetric assay,nephelometric assay and dot immunogold filtration assay in 106 pleural effusions with tuberculosis,carcinom a of non-tuberculosis infection.Results ADA and LAM -IgG activity in tuberculous pleural effusions were higher than others signific antly(P<0.01),and CRP in non-tuberculous pleural effusions was significan tly higher than in tuberculous pleural effusions.The sensitivity and specifity o f ADA,CRP and LAM-IgG combination were 95.7% and 98.1% for diagnosing tubercu lous pleural effusions;98.7% and 97.1% for diagnosing malignant pleural effusi ons.Conclusion ADA,CRP and LAM-IgG are useful parameters for differential diagnosis of pleural effusions.