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腺苷脱氨酶2在结核性胸膜炎诊断中的应用

[Adenosine deaminase 2 in the diagnosis of tuberculous pleuritis].

作者信息

Inase Naohiko, Tominaga Shinichirou, Yasui Makito, Tsukada Yoshikazu, Oukouchi Minoru, Miura Hirotarou

机构信息

Department of Internal Medicine, Yokosuka Kyosai Hospital, 1-16, Yonegahama-dori, Yokosuka-shi, Kanagawa 238-8558, Japan.

出版信息

Kekkaku. 2005 Dec;80(12):731-4.

Abstract

PURPOSE

We examined the usefulness of adenosine deaminase 2 (ADA2) in the diagnosis of tuberculous pleuritis.

SUBJECTS

A hundred cases, 78 male and 22 female, with pleural effusion were examined. With regard to pleural effusion, 18 cases were transudate and 82 cases (9 tuberculous pleuritis, 27 lung cancer, 8 mesothelioma, 5 malignant diseases except lung cancer and mesothelioma, 5 benign asbestos pleurisy, 10 empyema, 10 parapneumonic effusion, one SLE, one parasitic infection, and 6 undetermined etiology) were exudates. The last 6 cases with unknown origin were excluded in this study.

RESULTS

Pleural adenosine deaminase (ADA) was 90.4 +/- 22.4 U/l (mean +/- SD) and pleural ADA2 was 80.4 +/- 21.9 U/l in tuberculous pleuritis, both were significantly higher than those in non-tuberculous exudates (p < 0.001). In the diagnosis of tuberculous pleuritis, pleural ADA showed 100% sensitivity and 88% specificity, whereas pleural ADA2 showed 100% sensitivity and 91% specificity.

CONCLUSION

Pleural ADA2 is useful in the diagnosis of tuberculous pleuritis, which has similar sensitivity and a little better specificity compared with pleural ADA.

摘要

目的

我们研究了腺苷脱氨酶2(ADA2)在结核性胸膜炎诊断中的实用性。

对象

对100例胸腔积液患者进行了检查,其中男性78例,女性22例。关于胸腔积液,18例为漏出液,82例(9例结核性胸膜炎、27例肺癌、8例间皮瘤、5例非肺癌和间皮瘤的恶性疾病、5例良性石棉胸膜炎、10例脓胸、10例肺炎旁胸腔积液、1例系统性红斑狼疮、1例寄生虫感染以及6例病因不明)为渗出液。本研究排除了最后6例病因不明的病例。

结果

结核性胸膜炎患者的胸腔腺苷脱氨酶(ADA)为90.4±22.4 U/l(均值±标准差),胸腔ADA2为80.4±21.9 U/l,两者均显著高于非结核性渗出液(p<0.001)。在结核性胸膜炎的诊断中,胸腔ADA的敏感性为100%,特异性为88%,而胸腔ADA2的敏感性为100%,特异性为91%。

结论

胸腔ADA2在结核性胸膜炎的诊断中具有实用性,与胸腔ADA相比,其敏感性相似,特异性稍好。

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