Kartaloglu Zafer, Okutan Oguzhan, Bozkanat Erkan, Ugan M Harun, Ilvan Ahmet
Gulhane Military Medical Academia, Haydarpasa Training Hospital, Department of Pulmonology, Istanbul, Turkey.
Med Sci Monit. 2006 Nov;12(11):CR476-80.
This study was done to investigate the course of serum adenosine deaminase (sADA) level during pulmonary tuberculosis (TB) and its relationship with clinical, radiological, and laboratory parameters in TB patients.
MATERIAL/METHODS: sADA levels were measured at the beginning and after the first, second, and sixth months in 38 smear-positive TB patients. Chest X-rays were taken. Additionally, peripheral blood leukocyte and lymphocyte counts, erythrocyte sedimentation rate (ESR), and C reactive protein (CRP) levels were measured. Fifteen healthy persons were enrolled in the study as controls.
The level of sADA at the beginning was 33.2+/-13.9 U/l in the patients and 19.0+/-7.1 U/l in controls. The specificity and sensitivity were found to be 100% and 42%, respectively. The level of sADA showed elevation (45.1+/-10.6 U/l) after one month and gradually decreased in the second (34.6+/-10.1 U/l) and sixth months (24.6+/-4.7 U/l). ANOVA (post hoc Bonferroni) showed a significant difference in sADA levels between the beginning and the first month (p=0.005), the first and second months (p=0.016), and between the first month and the end of treatment (p<0.001). There was also a significant difference between sADA level at the end of treatment and the control value (p=0.01). During these times there were significant differences in the radiological course, peripheral blood lymphocyte count, ESR, and CRP levels.
sADA levels in TB patients showed a slight elevation in the first month, but it decreased during treatment in parallel with the effectiveness. This may have an association with lymphocytic activation.
本研究旨在调查肺结核（TB）患者血清腺苷脱氨酶（sADA）水平的变化过程及其与TB患者临床、影像学和实验室参数的关系。
材料/方法：对38例涂片阳性的TB患者在开始治疗时以及治疗第1、2和6个月后测量sADA水平。拍摄胸部X光片。此外，测量外周血白细胞和淋巴细胞计数、红细胞沉降率（ESR）和C反应蛋白（CRP）水平。15名健康人作为对照纳入研究。
患者开始时sADA水平为33.2±13.9 U/l，对照组为19.0±7.1 U/l。发现特异性和敏感性分别为100%和42%。sADA水平在1个月后升高（45.1±10.6 U/l），在第2个月（34.6±10.1 U/l）和第6个月（24.6±4.7 U/l）逐渐下降。方差分析（事后邦费罗尼检验）显示开始时与第1个月之间（p = 0.005）、第1个月与第2个月之间（p = 0.016）以及第1个月与治疗结束时之间sADA水平存在显著差异（p < 0.001）。治疗结束时sADA水平与对照值之间也存在显著差异（p = 0.01）。在此期间，影像学病程、外周血淋巴细胞计数、ESR和CRP水平存在显著差异。
TB患者的sADA水平在第1个月略有升高，但在治疗期间随疗效下降。这可能与淋巴细胞激活有关。
