腺苷脱氨酶检测在胸腔积液诊断中的临床价值

目的探讨腺苷脱氨酶（ADA）活性测定在胸腔积液诊断和抗结核疗效观察中的临床价值。方法对临床明确诊断的120例住院患者胸水和血清标本用氨显色法在日立7180生化仪测定其ADA活性值。结果结核性胸腔积液组ADA活性为（54．91±11．24）U／L，明显高于癌性胸腔积液组（19．25±9．73）U／L及炎性胸腔积液组（16．49±7．61）U／L，差异有统计学意义（P〈0．05）。ADA诊断结核性胸腔积液的敏感性为93．2％（41／44），特异性为97．6％（81／83）。结核性胸腔积液患者ADA活性治疗前（54．91±11．24）U／L与治疗后（9．12±6．24）U／L比较，差异有统计学意义（P〈0．05）。结论ADA可作为结核核性与非结核胸腔积液的重要鉴别指标之一及结核性胸膜炎患者病情进展监测的良好指标。

Clinical value of adenosine deaminase activity detection in diagnosing hydrothorax

To investigate the clinical value of adenosine deaminase（ADA） activity for diagnosing tuber- culous hydrothorax and investigating the therapeutic effect of antl-tuberculous therapy. Methods The ADA ac- tivity of pleural fluid and sermn specimens of 127 patients with hydrothorax were determined by ammonia color in Hitachi 7170 biochemical analyzer. Results The ADA activity was （54. 91±11.24） U/L in the tuberculosis group, higher than that of the cancerous hydrothorax group（ 19.25 ±9. 73 ） U/L and the inflammatory hydrotho- rax group （ 16.49± 7.61 ）U/L with statistical signifieance（ P 〈 0.05 ）. The sensitivity and specificity of ADA for diagnosing tuberculous hydrothorax were 93.2% （41/44） and 97.6% （81/83） respectively. The ADA activity was （54. 91±11.24） U/L before treatment and （ 9. 12±6. 24 ） U/L after treatment with statistical significance （P 〈 0. 05）. Conclusion The detection of ADA activity of hydrothorax may be as an indicator for distinguis- hing tuberculous and nontuberculous hydrothorax and for monitoring the progress of Tuberculous pleurisy patients＇ condition.