Smach M A, Garouch A, Charfeddine B, Ben Abdelaziz A, Dridi H, Krayem B, Limem K
Département de biochimie, Faculté de médecine de Sousse, Tunisie.
Ann Biol Clin (Paris). 2006 May-Jun;64(3):265-70.
The biological diagnosis of tuberculous pleurisy poses the problem of the time required to obtain results and of the sensitivity of the usual diagnostic methods. The determination of adenosine deaminase (ADA) activity has been proposed for the diagnosis of tuberculous pleural effusion and for the follow-up. In the present study, ADA in pleural effusion (p-ADA) and in serum (s-ADA) has been measured in 2 groups of patients: tuberculosis (27) and non-tuberculosis (53) patients. The upper limit of the normal values was fixed at 37 U/L. Comparing these 2 groups, we observed a specificity of 81.2% and a sensitivity of 66.6%. The PPV and the NPV were respectively 64.3% and 82.7%. We used p-ADA/s-ADA ratio for diagnosis of tuberculous pleural effusion, a threshold value of 1.8 gave a sensitivity of 82.6% and a specificity of 84.8%. Within the tuberculosis patient group, the activity of ADA decreased after the appropriate treatment initiation. Thus, the determination of ADA activity and/ or the p-ADA/s-ADA ratio, can help to recognize the tuberculosis origin of pleural effusions.
结核性胸膜炎的生物学诊断存在获得结果所需时间以及常用诊断方法敏感性的问题。腺苷脱氨酶（ADA）活性测定已被用于结核性胸腔积液的诊断及随访。在本研究中，对两组患者的胸腔积液（p-ADA）和血清（s-ADA）中的ADA进行了测定：结核病患者（27例）和非结核病患者（53例）。正常值上限设定为37 U/L。比较这两组，我们观察到特异性为81.2%，敏感性为66.6%。阳性预测值和阴性预测值分别为64.3%和82.7%。我们使用p-ADA/s-ADA比值诊断结核性胸腔积液，阈值为1.8时，敏感性为82.6%，特异性为84.8%。在结核病患者组中，开始适当治疗后ADA活性降低。因此，测定ADA活性和/或p-ADA/s-ADA比值有助于识别胸腔积液的结核病因。
