脑脊液和血清中的腺苷脱氨酶活性用于结核性脑膜炎的诊断。
Adenosine deaminase activity in cerebrospinal fluid and serum for the diagnosis of tuberculous meningitis.
作者信息
Cho Bang-Hoon, Kim Byeong C, Yoon Geum-Jin, Choi Seong-Min, Chang Jane, Lee Seung-Han, Park Man-Seok, Shin Jong Hee, Kim Myeong-Kyu, Cho Ki-Hyun
机构信息
Department of Neurology, Chonnam National University Medical School, Gwangju 501-757, Republic of Korea.
出版信息
Clin Neurol Neurosurg. 2013 Sep;115(9):1831-6. doi: 10.1016/j.clineuro.2013.05.017. Epub 2013 Jun 12.
OBJECTIVE
To evaluate the usefulness of serum and CSF adenosine deaminase (ADA) activity for the diagnosis of tuberculous meningitis (TBM) from other meningitis.
METHODS
We studied CSF and serum ADA activity for 83 cases of TBM, 148 of bacterial meningitis (BM), and 262 of viral or aseptic meningitis.
RESULTS
The mean ADA activities (IU/L) in CSF and serum were higher in TBM (11.80 ± 2.50, 30.28 ± 7.30) than in other types of meningitis (8.52 ± 3.60, 17.90 ± 9.20 in BM; 5.26 ± 1.90, 8.56 ± 5.9 in viral or aseptic meningitis). When we accepted a serum ADA activity cut-off value of 15 IU/L for the differential diagnosis of TBM and non-TBM with ROC analysis, the sensitivity was 84% and specificity was 82%. Combining CSF (≥ 10) and serum (≥ 15) ADA activity significantly increased overall specificity from 92% to 97% for the diagnosis of TBM.
CONCLUSIONS
The determination of CSF and serum ADA activity is a simple and reliable test for differentiating TBM from other types of meningitis.
目的
评估血清和脑脊液腺苷脱氨酶（ADA）活性在鉴别结核性脑膜炎（TBM）与其他脑膜炎中的作用。
方法
我们研究了83例结核性脑膜炎、148例细菌性脑膜炎（BM）以及262例病毒性或无菌性脑膜炎患者的脑脊液和血清ADA活性。
结果
结核性脑膜炎患者脑脊液和血清中的平均ADA活性（IU/L）（分别为11.80±2.50、30.28±7.30）高于其他类型脑膜炎患者（细菌性脑膜炎分别为8.52±3.60、17.90±9.20；病毒性或无菌性脑膜炎分别为5.26±1.90、8.56±5.9）。通过ROC分析，当我们将血清ADA活性临界值设定为15 IU/L用于鉴别结核性脑膜炎与非结核性脑膜炎时，敏感性为84%，特异性为82%。联合脑脊液（≥10）和血清（≥15）ADA活性可使结核性脑膜炎诊断的总体特异性从92%显著提高至97%。
结论
测定脑脊液和血清ADA活性是鉴别结核性脑膜炎与其他类型脑膜炎的一种简单可靠的检测方法。
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