Abrao F C, de Abreu I R L Bruno, Miyake D H, Busico M A M, Younes R N
Department of Thoracic Surgery, Hospital Santa Marcelina, São Paulo, Brazil.
Department of Pneumology, Instituto Clemente Ferreira, São Paulo, Brazil.
Int J Tuberc Lung Dis. 2014 Nov;18(11):1363-9. doi: 10.5588/ijtld.14.0257.
ADA levels in PF of 309 patients were analysed to investigate pleural effusion. All patients were evaluated for age, sex and presence of tuberculosis (TB) based on a positive pleural biopsy. Differences in ADA levels between groups were analysed using Kruskal-Wallis one-way analysis of variance. Logistic regression analysis was also carried out to predict the occurrence of TB. ADA cut-off levels were selected using the receiver operating characteristic (ROC) curve.
The mean PF ADA level was significantly higher in the tuberculous pleural group than in non-tuberculous pleural patients (63.3 ± 29 IU/l vs. 19 ± 31 IU/l, P < 0.001). There was a significant correlation between PF ADA levels and age: for patients aged ⩾45 years, the ROC curve for ADA had an area under the curve of 0.91. An ADA level of 29 IU/l resulted in a sensitivity of 88.6% and specificity of 91.5%.
There is a significant negative correlation between PF ADA level and age. The use of a lower ADA cut-off reduces the number of false-negative results.
1）确定影响胸腔积液（PF）中腺苷脱氨酶（ADA）水平的因素；2）为巴西人群确定ADA的最佳临界值水平。
分析309例患者胸腔积液中的ADA水平以研究胸腔积液。所有患者均根据胸膜活检阳性情况评估年龄、性别及是否存在结核病（TB）。采用Kruskal-Wallis单因素方差分析比较各组间ADA水平的差异。还进行了逻辑回归分析以预测结核病的发生。使用受试者工作特征（ROC）曲线选择ADA临界值水平。
结核性胸腔积液组的平均PF ADA水平显著高于非结核性胸腔积液患者（63.3±29 IU/l对19±31 IU/l，P<0.001）。PF ADA水平与年龄之间存在显著相关性：对于年龄≥45岁的患者，ADA的ROC曲线下面积为0.91。ADA水平为29 IU/l时，敏感性为88.6%，特异性为91.5%。
PF ADA水平与年龄之间存在显著负相关。使用较低的ADA临界值可减少假阴性结果的数量。
