中华结核和呼吸杂志
中華結覈和呼吸雜誌
중화결핵화호흡잡지
Chinese Journal of Tuberculosis and Respiratory Diseases
2010年
4期
273-275
,共3页
尉艳霞%童朝晖%龚娟妮%王臻%王晓娟%徐莉莉%伍燕兵%李红杰%王辰
尉豔霞%童朝暉%龔娟妮%王臻%王曉娟%徐莉莉%伍燕兵%李紅傑%王辰
위염하%동조휘%공연니%왕진%왕효연%서리리%오연병%리홍걸%왕신
腺苷%脱氨酶%结核%胸腔积液%ROC曲线
腺苷%脫氨酶%結覈%胸腔積液%ROC麯線
선감%탈안매%결핵%흉강적액%ROC곡선
Adenosine deaminase%Tuberculosis%Pleural effusion%ROC curve
目的 探讨胸腔积液和血清中腺苷脱氨酶(ADA)对鉴别结核性胸膜炎及恶性胸腔积液的临床价值.方法 回顾性分析91例经内科胸腔镜胸膜活检病理确诊为结核性胸腔积液(结核组49例)和恶性胸腔积液(恶性组42例)患者的胸腔积液及血清中ADA活性,应用受试者工作曲线(ROC曲线)确定结核性胸膜炎患者胸腔积液ADA的最佳临界值.结果 结核组胸腔积液ADA活性和胸腔积液ADA与血清ADA比值分别为(46±26)U/L和4.1±4.0,明显高于恶性组的(16±8)U/L和1.7±1.2,差异均有统计学意义(t值分别为7.383和3.852,均P＜0.01),结核组和恶性组的血清ADA活性分别为(13±5)U/L和(12±6)U/L,差异无统计学意义(t=1.582,P＞0.05).应用ROC曲线确定胸腔积液ADA诊断结核性胸膜炎的最佳临界值为28.7 U/L,灵敏度为75.5%,特异度为95.2%.结论 胸腔积液ADA活性可以作为鉴别结核性和恶性胸腔积液的重要指标,对结核性胸膜炎有较高的临床诊断价值,而血清ADA活性对鉴别两者无临床意义.
目的 探討胸腔積液和血清中腺苷脫氨酶(ADA)對鑒彆結覈性胸膜炎及噁性胸腔積液的臨床價值.方法 迴顧性分析91例經內科胸腔鏡胸膜活檢病理確診為結覈性胸腔積液(結覈組49例)和噁性胸腔積液(噁性組42例)患者的胸腔積液及血清中ADA活性,應用受試者工作麯線(ROC麯線)確定結覈性胸膜炎患者胸腔積液ADA的最佳臨界值.結果 結覈組胸腔積液ADA活性和胸腔積液ADA與血清ADA比值分彆為(46±26)U/L和4.1±4.0,明顯高于噁性組的(16±8)U/L和1.7±1.2,差異均有統計學意義(t值分彆為7.383和3.852,均P＜0.01),結覈組和噁性組的血清ADA活性分彆為(13±5)U/L和(12±6)U/L,差異無統計學意義(t=1.582,P＞0.05).應用ROC麯線確定胸腔積液ADA診斷結覈性胸膜炎的最佳臨界值為28.7 U/L,靈敏度為75.5%,特異度為95.2%.結論 胸腔積液ADA活性可以作為鑒彆結覈性和噁性胸腔積液的重要指標,對結覈性胸膜炎有較高的臨床診斷價值,而血清ADA活性對鑒彆兩者無臨床意義.
목적 탐토흉강적액화혈청중선감탈안매(ADA)대감별결핵성흉막염급악성흉강적액적림상개치.방법 회고성분석91례경내과흉강경흉막활검병리학진위결핵성흉강적액(결핵조49례)화악성흉강적액(악성조42례)환자적흉강적액급혈청중ADA활성,응용수시자공작곡선(ROC곡선)학정결핵성흉막염환자흉강적액ADA적최가림계치.결과 결핵조흉강적액ADA활성화흉강적액ADA여혈청ADA비치분별위(46±26)U/L화4.1±4.0,명현고우악성조적(16±8)U/L화1.7±1.2,차이균유통계학의의(t치분별위7.383화3.852,균P＜0.01),결핵조화악성조적혈청ADA활성분별위(13±5)U/L화(12±6)U/L,차이무통계학의의(t=1.582,P＞0.05).응용ROC곡선학정흉강적액ADA진단결핵성흉막염적최가림계치위28.7 U/L,령민도위75.5%,특이도위95.2%.결론 흉강적액ADA활성가이작위감별결핵성화악성흉강적액적중요지표,대결핵성흉막염유교고적림상진단개치,이혈청ADA활성대감별량자무림상의의.
Objective To investigate the clinical value of pleural fluid adenosine deaminase (ADA) activity in differentiating tuberculous pleural effusions (TPE) from malignant effusions.Methods The serum and pleural adenosine deaminase activity of 91 cases confirmed by pleural biopsy through medical thoracoscopy were retrospectively analyzed.TPE was confirmed in 49 cases and malignant effusion in 42 cases.The o ptimal cutoff for TPE was determined by using the ROC curve.Results The mean pleural ADA was significantly (t = 7.383,P ＜ 0.01) higher in PTE (46 ± 26) U/L as compared to malignancy (16 ± 8) U/L,so was the pleural fluid/serum ADA ratio (4.1 ±4.0 vs 1.76 ± 1.2,t =3.852,P ＜0.01),but there was no statistically significant difference between malignant and tuberculous effusion in serum ADA activity [(13 ±5) U/L vs (12±6) U/L,t= 1.582,P ＞ 0.05].The cutoff value of pleural ADA for PTE was 28.7 U/L,with a sensitivity of 75.5% and a specificity of 95.2%.Conclusions Pleural fluid,but not serum,ADA activity,can be used for the differentiation between tuberculous and malignant pleural effusions.
