Kubota M, Katagiri M, Imasaki T, Yanase N, Soma K, Tomita T
Department of Internal Medicine, Isehara Kyodo Hospital, Kanagawa, Japan.
Nihon Kokyuki Gakkai Zasshi. 1999 May;37(5):374-9.
We studied adenosine deaminase (ADA) activity in bronchoalveolar lavage fluid (BALF) specimens from 24 patients with sarcoidosis. Mean BALF-ADA activity was significantly (p < 0.0001) elevated in patients with sarcoidosis (1.02 +/- 1.01 IU/L, mean +/- SD) compared to the subjects in a healthy control group (0.08 +/- 0.29 IU/L). In the sarcoidosis patients with high BALF-ADA activity (> or = 1.0 IU/L), AaDO2 was significantly (p < 0.0001) elevated compared to its level in patients with normal BALF-ADA activity (< 1.0 IU/L). BALF-ADA activity was significantly (p < 0.01) higher in patients who exhibited lung-field accumulations on 67Ga scintigrams compared to those with no accumulations, and significantly (p < 0.001) higher in patients undergoing corticosteroid treatment compared to in those patients who did not receive such treatment. These findings were similar to the results of studies using data on BALF-ADA/albumin ratios. Furthermore, they suggest that the localized production of ADA may increase in sarcoidosis patients displaying 67Ga scintigram lung-field accumulations with increased AaDO2, and that BALF-ADA activity may be a useful indicator of disease activity and the need for treatment.
我们研究了24例结节病患者支气管肺泡灌洗(BAL)标本中的腺苷脱氨酶(ADA)活性。与健康对照组受试者(0.08±0.29 IU/L)相比,结节病患者的平均BALF-ADA活性显著升高(p<0.0001)(1.02±1.01 IU/L,平均值±标准差)。在BALF-ADA活性高(≥1.0 IU/L)的结节病患者中,与BALF-ADA活性正常(<1.0 IU/L)的患者相比,AaDO2显著升高(p<0.0001)。与67Ga闪烁扫描无肺野积聚的患者相比,67Ga闪烁扫描显示肺野积聚的患者的BALF-ADA活性显著更高(p<0.01),与未接受皮质类固醇治疗的患者相比,接受皮质类固醇治疗的患者的BALF-ADA活性显著更高(p<0.001)。这些发现与使用BALF-ADA/白蛋白比率数据的研究结果相似。此外,它们表明,在显示67Ga闪烁扫描肺野积聚且AaDO2增加的结节病患者中,ADA的局部产生可能增加,并且BALF-ADA活性可能是疾病活动和治疗需求的有用指标。