Blanco Vaca F, Mayos Pérez M, Pérez Domínguez C, Gómez Gerique J A, Rubio Gil J, Cornudella Mir R, González Sastre F
Rev Clin Esp. 1989 Jan;184(1):7-11.
In this paper we present the results of a study about the diagnostic utility of Adenosine Deaminase (ADA) determination for diagnosing the tuberculous pleural effusion. We carried out this study in 71 patients who came to our Hospital and were diagnosed for pleural effusion. The ADA determination was made in sera and pleural effusion of all these patients. Also we determined how much of this ADA activity was linked to microsomes or not (soluble ADA), by ultracentrifugation as a separative method. Taking as a base the data obtained and using 43 U/l as cutoff point, the Diagnostic Sensitivity of ADA determined in pleural liquid calculated was 1. This means that all patients with tuberculous pleural effusions had ADA activities higher than 43 U/l in their pleural liquid. On the other hand, Diagnostic Specificity was of 0.83. This was due to the existence of 10 false positives: 2 malignancies, 3 empyemas, 1 postpneumonia, 1 secondary to thromboembolic pulmonary disease, 1 secondary to rheumatoid arthritis and 2 of unknown origin. Results obtained show the utility, with some limitations, of ADA determination in pleural liquid in order to diagnose tuberculous pleural effusions. Neither ADA determination in sera nor quantity of ADA linked to microsomes or solubles ADA in pleural liquid seem to have great clinical interest.
在本文中，我们展示了一项关于腺苷脱氨酶（ADA）测定对结核性胸腔积液诊断效用的研究结果。我们对71名前来我院并被诊断为胸腔积液的患者进行了此项研究。对所有这些患者的血清和胸腔积液进行了ADA测定。此外，我们通过超速离心作为分离方法，确定了这种ADA活性中有多少与微粒体相关或不相关（可溶性ADA）。以获得的数据为基础，将43 U/l作为临界值，计算得出胸腔积液中ADA测定的诊断敏感性为1。这意味着所有结核性胸腔积液患者的胸腔积液中ADA活性均高于43 U/l。另一方面，诊断特异性为0.83。这是由于存在10例假阳性：2例恶性肿瘤、3例脓胸、1例肺炎后、1例继发于血栓栓塞性肺病、1例继发于类风湿性关节炎以及2例病因不明。所得结果表明，胸腔积液中ADA测定对于诊断结核性胸腔积液具有一定效用，但存在一些局限性。血清中的ADA测定以及胸腔积液中与微粒体或可溶性ADA相关的ADA量似乎都没有太大的临床意义。
