脑脊液腺苷脱氨酶测定对诊断小儿结核性脑膜炎的意义

目的探讨脑脊液腺苷脱氨酶（ADA）测定对小儿结核性脑膜炎诊断的临床意义. 方法对确诊的37例结核性脑膜炎、38例化脓性脑膜炎、40例病毒性脑炎及40例非脑炎患儿采用全自动生化分析仪检测脑脊液ADA. 结果结核性脑膜炎患儿脑脊液ADA明显高于其它各组,差异有统计学意义.以ADA＞8U/L作为阳性阈值,诊断结核性脑膜炎的敏感度、特异度、准确度、阳性预测值、阴性预测值分别为81.1%、98.3%、94.2%、93.8%、94.4%. 结论脑脊液腺苷脱氨酶可作为诊断小儿结核性脑膜炎的重要参考指标.

The significance of determination of adenosine deaminase in diagnosis of cerebrospinal fluid from infantile tuberculous meningitis patients

Objective To investigate the clinical significance of determination of adenosine deaminase (ADA) from cerebrospinal fluid in diagnosis of infantile tuberculous meningitis patients. Methods The activity of ADA in cerebrospinal fluid of 37 patients with tuberculous meningitis,38 patients with bacterial meningitis,40 patients with viral meningitis and 40 patients without encephalitis (as control) were determined with automatic biochemical analyzer. Results The levels of cerebrospinal fluid ADA activity in patients with tuberculous meningitis were significantly higher than the other patients with bacterial meningitis, viral enteritis and the control (P<0.01). Taking ADA>8U/L as a positive threshold, sensitivity, specificity, accuracy, positive predicative value and negative predicative value were 81.1%, 98.3%, 94.2%,93.8%, 94.4%, respectively. Conclusion ADA in cerebrospinal fluid is an important reference indicator in diagnosis of infantile tuberculous meningitis.