腺苷脱氨酶检测在诊断HIV感染合并胸膜结核患者中的应用价值

Usefulness of Adenosine Deaminase Assay in Diagnosis of Patients with HIV Infection and Pleural Tuberculosis.

作者信息

Yusti Gabriel, Fielli Mariano, Gonzalez Alejandra, Torales Graciela, Zapata Alejandra, Ceccato Adrian

机构信息

Pneumology Service, Hospital Nacional Alejandro Posadas, El Palomar 1684, Argentina.

Infectious Diseases Service, Hospital Nacional Alejandro Posadas, El Palomar 1684, Argentina.

出版信息

Med Sci (Basel). 2018 Nov 13;6(4):101. doi: 10.3390/medsci6040101.

DOI:10.3390/medsci6040101

PMID:30428535

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6313798/

Abstract

The utility of the adenosine deaminase (ADA) assay in the diagnosis of patients with pleural tuberculosis (TB) and human immunodeficiency virus (HIV) infection is controversial. Forty-eight HIV positive patients with pleural effusion were evaluated; ADA assay was obtained in forty-three of them. Twenty-five patients presented diagnosis of TB. Patients with diagnosis of TB showed a median value of ADA of 70 IU/L (interquartile range (IQR) 41⁻89) and the non-TB group a median of 27.5 IU/L (IQR 13.5⁻52). Patients with diagnosis of TB had a median cluster of differentiation 4 (CD4) count of 174 (IQR 86⁻274) and the non-TB group had a median of 134 (IQR 71⁻371). Receiver operating characteristic curve was performed with an area under the curve of 0.79. The best cut-off obtained was 35 IU/L with a sensibility of 80% and a specificity of 66%. There was no correlation between CD4 lymphocytes count and the value of ADA in the TB patient group.

摘要

腺苷脱氨酶（ADA）检测在诊断合并胸膜结核（TB）和人类免疫缺陷病毒（HIV）感染患者中的作用存在争议。对48例HIV阳性且伴有胸腔积液的患者进行了评估；其中43例进行了ADA检测。25例患者被诊断为TB。诊断为TB的患者ADA中位数为70 IU/L（四分位间距（IQR）41⁻89），非TB组中位数为27.5 IU/L（IQR 13.5⁻52）。诊断为TB的患者分化簇4（CD4）计数中位数为174（IQR 86⁻274），非TB组中位数为134（IQR 71⁻371）。绘制了受试者工作特征曲线，曲线下面积为0.79。得到的最佳截断值为35 IU/L，敏感性为80%，特异性为66%。TB患者组中CD4淋巴细胞计数与ADA值之间无相关性。