El Jahiri Y, Chellak S, Garcia C, Ceppa F, Burnat P
Service de Biochimie Toxicologie et Pharmacologie Cliniques, HIA Bégin, Paris.
Ann Biol Clin (Paris). 2006 Mar-Apr;64(2):117-24.
Tuberculosis may affect several organs and its prevalence is continuously increasing. Laboratory diagnosis still remains difficult. Adenosine deaminase (Ada) is an enzyme which contributes to purine metabolism and its presence in lymphocyte, monocyte and macrophage cells is associated with T cells mediated immunity. Many studies have shown the usefulness of Ada determination in various biological fluids for the diagnosis of tuberculosis. In pleural fluid, cutoff vary from 33 to 48 U/L, with sensitivity higher than 80% and specificity near 100%. In peritoneal fluid the cutoff value is 30 U/L. In cerebrospinal fluid, the value of 7 U/L can make discriminate negative and positive cases with a good sensitivity and specificity. The data from the literature show that 50 U/L in pericardic fluid is a reliable threshold for tuberculosis diagnosis. Ada determination in serum is not as relevant as in others fluids because of its low specificity. Ada measurement in biological fluids, easy and not expensive, may be add to other biological tests for tuberculosis diagnosis.
结核病可累及多个器官，其患病率持续上升。实验室诊断仍然困难。腺苷脱氨酶（Ada）是一种参与嘌呤代谢的酶，其在淋巴细胞、单核细胞和巨噬细胞中的存在与T细胞介导的免疫相关。许多研究表明，测定各种生物体液中的Ada对结核病诊断有用。在胸腔积液中，临界值为33至48 U/L，敏感性高于80%，特异性接近100%。在腹腔积液中，临界值为30 U/L。在脑脊液中，7 U/L的值可有效区分阴性和阳性病例，敏感性和特异性良好。文献数据表明，心包积液中50 U/L是结核病诊断的可靠阈值。由于血清中Ada的特异性较低，因此血清中Ada的测定不如其他体液相关。生物体液中Ada的测量简便且成本不高，可作为结核病诊断的其他生物学检测的补充。
