腹水腺苷脱氨酶和结核抗体检测对鉴别恶性腹水及结核性腹水的价值

目的 评价腺苷脱氨酶和结核抗体对鉴别恶性腹水和结核性腹水的临床价值。方法 采用改良的Martineck法和金标免疫斑点法（DIGFA）对35例结核性腹水，31例恶性腹水的腹水腺苷脱氨酶（ADA）和结核性抗体（PPD）水平进行了检测。结果 结核性腹水ADA和PPD水平明显高于恶性腹水，以ADA＞45U／L作为阳性标准，其对结核性腹水的敏感性为100％，特异性为97．1％，准确性为98．5％，腹水结核抗体对结核性腹水的敏感性为93．5％，特异性为94．3％，准确性为95．38％。结论 腹水ADA和PPD检测对鉴别恶性腹水和结核性腹水有重要的临床价值，腹水ADA水平升高和PPD阳性支持结核性腹水，反之，则支持恶性腹水诊断。

The Tests for Anti-TB and Adenosine Deaminase in Ascites for Distinguishing Between Tuberculous Ascites and Carcinous Ascites

Objective To evaluate the tests for anti TB and adenosine deaminase (ADA) in ascites in an attempt to distinguish between tuberculous ascites and carcinous ascites. Methods DIGFA was used to test anti TB and Martineck's method was used to determine the level of ADA in 35 cases of tuberculous ascites and 31 cases of carcinous ascites. Results The levels of anti TB and ADA in ascites were significantly higer in tuberculous ascites than those in carcinous ascites ( P <0.01). When the level of ADA was higher than 45 U/L, the sensitivity, specificity and accuracy in the diagnosis of tuberculous ascites were 100%, 97.1% and 98.5%, respectively. When the result of anti TB test was positive, the sensitivity,specificity and accuracy in the diagnosis of tuberculous ascites were 93 5%, 94 3% and 95 38%, respectively. Conclusion The tests for anti TB and ADA in ascites are of important clinical value to differential diagnosis in an attempt to distinguish between tuberculous ascites and carcinous ascites.