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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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cf02/6313798/91ac08aa64f6/medsci-06-00101-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cf02/6313798/90823ac6b1bb/medsci-06-00101-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cf02/6313798/91ac08aa64f6/medsci-06-00101-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cf02/6313798/90823ac6b1bb/medsci-06-00101-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cf02/6313798/91ac08aa64f6/medsci-06-00101-g002.jpg

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Usefulness of Adenosine Deaminase Assay in Diagnosis of Patients with HIV Infection and Pleural Tuberculosis.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
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本文引用的文献

1
Tuberculous pleural effusion.结核性胸腔积液
J Thorac Dis. 2016 Jul;8(7):E486-94. doi: 10.21037/jtd.2016.05.87.
2
A systematic review of the epidemiology, immunopathogenesis, diagnosis, and treatment of pleural TB in HIV-infected patients.对HIV感染患者胸膜结核的流行病学、免疫发病机制、诊断及治疗的系统评价。
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Adenosine deaminase activity is a sensitive marker for the diagnosis of tuberculous pleuritis in patients with very low CD4 counts.
腺苷脱氨酶活性是诊断CD4计数极低患者结核性胸膜炎的敏感标志物。
PLoS One. 2008 Jul 30;3(7):e2788. doi: 10.1371/journal.pone.0002788.
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Diagnostic accuracy of adenosine deaminase in tuberculous pleurisy: a meta-analysis.腺苷脱氨酶在结核性胸膜炎中的诊断准确性:一项荟萃分析。
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Adenosine deaminase activity in cerebrospinal fluid of HIV-infected patients: limited value for diagnosis of tuberculous meningitis.HIV感染患者脑脊液中的腺苷脱氨酶活性:对结核性脑膜炎诊断的价值有限。
Eur J Clin Microbiol Infect Dis. 2004 Jun;23(6):471-6. doi: 10.1007/s10096-004-1110-z. Epub 2004 May 13.
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Diagnostic value of pleural fluid adenosine deaminase in tuberculous pleuritis with reference to HIV coinfection and a Bayesian analysis.胸腔积液腺苷脱氨酶在合并HIV感染的结核性胸膜炎中的诊断价值及贝叶斯分析
Chest. 1999 Jul;116(1):97-103. doi: 10.1378/chest.116.1.97.
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Diagnostic value of pleural adenosine deaminase in tuberculous effusions of immunocompromised hosts.免疫功能低下宿主结核性胸腔积液中胸膜腺苷脱氨酶的诊断价值
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