Yoshino Yusuke, Wakabayashi Yoshitaka, Seo Kazunori, Koga Ichiro, Kitazawa Takatoshi, Ota Yasuo
Department of Internal Medicine, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo 173-8606, Japan.
J Clin Med Res. 2015 Jan;7(1):41-4. doi: 10.14740/jocmr1980w. Epub 2014 Oct 16.
A high concentration of hyaluronic acid in pleural fluid is suggestive of malignant mesothelioma. However, a relatively high concentration of hyaluronic acid was also seen in the pleural fluid of patients with benign inflammatory diseases. To show the utility of measuring hyaluronic acid levels in pleural fluid to diagnose tuberculous pleurisy, we compared the clinical features and levels of hyaluronic acid in the pleural fluid of patients with and without tuberculous pleurisy.
We enrolled 27 patients with infective pleurisy admitted at Teikyo University Hospital from January 2010 to December 2013. Ten patients were diagnosed with tuberculous pleurisy, and 17 with non-tuberculous pleurisy. We reviewed the clinical features and data of all 27 patients and compared the two groups. We analyzed and compared the concentration of hyaluronic acid and adenosine deaminase in their pleural fluid.
Patients with tuberculous pleurisy tended to have significantly higher concentrations of hyaluronic acid and adenosine deaminase in their pleural fluid (tuberculous pleurisy patients vs. other infective pleurisy patients: hyaluronic acid (× 10(3) ng/mL); 42.9 ± 23.3 vs. 16.8 ± 17.9, P = 0.003, adenosine deaminase (IU/L); 89.7 ± 33.3 vs. 74.0 ± 90.9, P = 0.032). Receiver operating characteristic analysis revealed no significant difference in the area under the curve of hyaluronic acid and adenosine deaminase volumes in pleural fluid, suggesting their equivalent value as major diagnostic tools for tuberculosis pleurisy.
Hyaluronic acid concentration in pleural fluid can be a valuable tool for the diagnosis of tuberculous pleurisy.
胸腔积液中高浓度的透明质酸提示恶性间皮瘤。然而，良性炎症性疾病患者的胸腔积液中也可见相对较高浓度的透明质酸。为了证明检测胸腔积液中透明质酸水平对诊断结核性胸膜炎的实用性，我们比较了有和没有结核性胸膜炎患者的临床特征及胸腔积液中透明质酸水平。
我们纳入了2010年1月至2013年12月在帝京大学医院住院的27例感染性胸膜炎患者。10例被诊断为结核性胸膜炎，17例为非结核性胸膜炎。我们回顾了所有27例患者的临床特征和数据并比较了两组。我们分析并比较了他们胸腔积液中透明质酸和腺苷脱氨酶的浓度。
结核性胸膜炎患者胸腔积液中的透明质酸和腺苷脱氨酶浓度往往显著更高（结核性胸膜炎患者与其他感染性胸膜炎患者比较：透明质酸（×10(3) ng/mL）；42.9±23.3 对 16.8±17.9，P = 0.003，腺苷脱氨酶（IU/L）；89.7±33.3 对 74.0±90.9，P = 0.032）。受试者工作特征分析显示胸腔积液中透明质酸和腺苷脱氨酶含量曲线下面积无显著差异，表明它们作为结核性胸膜炎主要诊断工具的价值相当。
胸腔积液中透明质酸浓度可作为诊断结核性胸膜炎的有价值工具。
