Suleman Amir, Kamal Muhammad, Abbasi Munir Ahmad
Department of Pulmonology, Ayub Teaching Hospital, Abbottabad, Pakistan.
Department of Community Medicine, Poonch Medical College, Rawalakot, AJK.
J Ayub Med Coll Abbottabad. 2016 Apr-Jun;28(2):245-248.
Early diagnosis and management of tuberculosis is essential for decreasing the disease burden. Pakistan is one of the few countries of world with a very high burden of tuberculosis. Many diagnostic tests are available for detection of tuberculosis but each is fraught with certain limitations of its own.
This study was a cross sectional validation study that sought to determine the validity of pleural fluid adenosine deaminase levels for diagnosis of tuberculous pleural effusion.
A total of 160 patients with exudative lymphocytic pleural effusions were enrolled in this study. The mean pleural fluid ADA level was 52.18±1.98 U/L. The mean pleural fluid ADA level in patients diagnosed to have tuberculosis on pleural biopsy/histopathology was higher as compared to patients who did not have tuberculous pleural effusion 52.16±2.4 U/L vs 38.6±3.14 U/L. The difference was found to be statistically significant between the two groups (p<0.05). The sensitivity, specificity, ppv and npv of pleural fluid ADA level were 88.88%, 77.04%, 86.28% and 81.04% respectively.
Despite wide variations in the reported sensitivity and specificity of pleural fluid ADA level, it can be used as a surrogate for pleural biopsy when the latter is not feasible.
结核病的早期诊断和管理对于减轻疾病负担至关重要。巴基斯坦是世界上结核病负担极高的少数国家之一。有许多诊断测试可用于检测结核病，但每种测试都有其自身的某些局限性。
本研究是一项横断面验证研究，旨在确定胸腔积液腺苷脱氨酶水平对结核性胸腔积液诊断的有效性。
本研究共纳入160例渗出性淋巴细胞性胸腔积液患者。胸腔积液ADA平均水平为52.18±1.98 U/L。经胸腔活检/组织病理学诊断为结核病的患者胸腔积液ADA平均水平高于无结核性胸腔积液的患者，分别为52.16±2.4 U/L和38.6±3.14 U/L。两组之间差异有统计学意义（p<0.05）。胸腔积液ADA水平的敏感性、特异性、阳性预测值和阴性预测值分别为88.88%、77.04%、86.28%和81.04%。
尽管报道的胸腔积液ADA水平的敏感性和特异性差异很大，但当胸腔活检不可行时，它可作为胸腔活检的替代方法。
