比较结核性脑膜炎患者脑脊液中腺苷脱氨酶水平和脑脊液聚合酶链反应结果。
To compare CSF adenosine deaminase levels and CSF-PCR for tuberculous meningitis.
作者信息
Rana S V, Chacko F, Lal V, Arora S K, Parbhakar S, Sharma Sanjeev K, Singh K
机构信息
Department of Gastroenterology, Postgraduate Institute of Medical Education And Research, Chandigarh, India.
出版信息
Clin Neurol Neurosurg. 2010 Jun;112(5):424-30. doi: 10.1016/j.clineuro.2010.02.012. Epub 2010 Mar 29.
This study was planned to compare the adenosine deaminase (ADA) levels and polymerase chain reaction (PCR) in cerebrospinal fluid (CSF) as a rapid method to diagnose tuberculosis meningitis (TBM). Fifty-four adult patients with suspected TBM and 37 controls were included in this study. The median ADA level was 21U/L of most likely TBM, 14U/L of unconfirmed TBM and 5U/L of controls. PCR for Mycobacterium tuberculosis was positive in 12 out of 27 most likely TBM cases, 5 out of 27 unconfirmed TBM cases and 3 out of 37 controls. Using a cut off level of >10U/L, CSF-ADA had a sensitivity of 92.5% and specificity of 97% for the diagnosis of TBM. PCR for M. tuberculosis had a sensitivity of 44.5% and specificity 92% in the most likely TBM cases. This study shows that CSF-ADA is a more sensitive indicator than PCR for the diagnosis of M. tuberculosis.
本研究旨在比较脑脊液（CSF）中腺苷脱氨酶（ADA）水平及聚合酶链反应（PCR），作为诊断结核性脑膜炎（TBM）的一种快速方法。本研究纳入了54例疑似TBM的成年患者和37例对照。最可能为TBM患者的ADA水平中位数为21U/L，未确诊TBM患者为14U/L，对照为5U/L。结核分枝杆菌PCR检测在27例最可能为TBM的病例中有12例呈阳性，27例未确诊TBM病例中有5例呈阳性，37例对照中有3例呈阳性。采用>10U/L的临界值时，CSF-ADA诊断TBM的敏感性为92.5%，特异性为97%。在最可能为TBM的病例中，结核分枝杆菌PCR检测的敏感性为44.5%，特异性为92%。本研究表明，CSF-ADA在诊断结核分枝杆菌方面是比PCR更敏感的指标。
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