Sakuraba Motoki, Masuda Kimihiko, Hebisawa Akira, Sagara Yuzo, Komatsu Hikotaro
Department of Thoracic Surgery, National Hospital Organization Tokyo Hospital, Japan.
Ann Thorac Cardiovasc Surg. 2009 Oct;15(5):294-6.
We investigated the incidence of tuberculous pleurisy among patients with adenosine deaminase (ADA) levels of 50 IU/L or less in a pleural effusion, and without a previous diagnosis of carcinomatous pleurisy or Mycobacterium tuberculosis.
Subjects were selected from patients who had undergone pleural biopsy by thoracoscopy at National Hospital Organization Tokyo Hospital from January 1995 to November 2004, and who had ADA levels of less than 50 IU/L in pleural fluid obtained preoperatively by thoracentesis. In all subjects, smear, culture, and polymerase chain reaction for Mycobacterium tuberculosis were negative.
Of 138 patients who underwent thoracoscopic pleural biopsy, a total of 50 had effusions with ADA levels of less than 50 IU/L. Six (12%) of these patients were diagnosed with tuberculous pleurisy after biopsy. Three patients with an effusion ADA level of 35 IU/L or less were diagnosed with tuberculous pleurisy.
Occult tuberculous pleurisy is significantly common in patients with pleural effusion ADA levels of 50 IU/L or less and who may otherwise be diagnosed with nonspecific pleurisy.
我们调查了胸腔积液中腺苷脱氨酶（ADA）水平为50 IU/L或更低、且既往未诊断为癌性胸膜炎或肺结核的患者中结核性胸膜炎的发病率。
研究对象选自1995年1月至2004年11月在东京国立医院机构接受胸腔镜胸膜活检的患者，这些患者术前经胸腔穿刺获得的胸腔积液中ADA水平低于50 IU/L。所有研究对象的结核分枝杆菌涂片、培养及聚合酶链反应均为阴性。
在138例行胸腔镜胸膜活检的患者中，共有50例胸腔积液ADA水平低于50 IU/L。其中6例（12%）患者活检后被诊断为结核性胸膜炎。3例胸腔积液ADA水平为35 IU/L或更低的患者被诊断为结核性胸膜炎。
隐匿性结核性胸膜炎在胸腔积液ADA水平为50 IU/L或更低、否则可能被诊断为非特异性胸膜炎的患者中显著常见。
