Department of Tuberculosis, Shandong Provincial Chest Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China.
Department of Geriatrics, Shandong Mental Health Center, Jinan, China.
BMC Infect Dis. 2021 May 25;21(1):473. doi: 10.1186/s12879-021-06209-1.
Until now, the influential factors associated with pleural adenosine deaminase (ADA) activity among children remain unclear. This retrospective study was therefore conducted aiming to investigate the factors associated with negative pleural ADA results in the diagnosis of childhood pleural tuberculosis (TB).
Between January 2006 and December 2019, children patients with definite or possible pleural TB were recruited for potential analysis. Then, patients were stratified into two categories: negative pleural ADA results group (experimental group, ≤40 U/L) and positive pleural ADA results group (control group, > 40 U/L). Univariate and multivariate logistic regression analyses were performed to estimate risk factors for negative pleural ADA results.
A total of 84 patients with pleural TB were recruited and subsequently classified as experimental (n = 17) and control groups (n = 67). Multivariate analysis (Hosmer-Lemeshow goodness-of-fit test: χ = 1.881, df = 6, P = 0.930) revealed that variables, such as chest pain (age-adjusted OR = 0.0510, 95% CI: 0.004, 0.583), pleural total protein (≤45.3 g/L, age-adjusted OR = 27.7, 95% CI: 2.5, 307.7), pleural lactate dehydrogenase (LDH, ≤505 U/L, age-adjusted OR = 59.9, 95% CI: 4.2, 857.2) and blood urea nitrogen (≤3.2 mmol/L, age-adjusted OR = 32.0, 95% CI: 2.4, 426.9), were associated with negative pleural ADA results when diagnosing childhood pleural TB.
Our findings demonstrated that chest pain, pleural total protein, pleural LDH, and blood urea nitrogen were associated with a negative pleural ADA result for the diagnosis of pleural TB among children. When interpreting pleural ADA levels in children with these characteristics, a careful clinical assessment is required for the pleural TB diagnosis.
迄今为止，儿童胸腔腺苷脱氨酶（ADA）活性相关的影响因素仍不清楚。本回顾性研究旨在探讨与儿童胸腔结核（TB）诊断中胸腔 ADA 结果阴性相关的因素。
2006 年 1 月至 2019 年 12 月，纳入了确诊或疑似胸腔 TB 的患儿患者进行潜在分析。然后，患者分为两组：胸腔 ADA 结果阴性组（实验组，≤40U/L）和胸腔 ADA 结果阳性组（对照组，>40U/L）。采用单变量和多变量逻辑回归分析来评估胸腔 ADA 结果阴性的危险因素。
共纳入 84 例胸腔 TB 患儿，随后分为实验组（n=17）和对照组（n=67）。多变量分析（Hosmer-Lemeshow 拟合优度检验：χ²=1.881，df=6，P=0.930）表明，胸痛（年龄校正比值比[OR] = 0.0510，95%可信区间：0.004，0.583）、胸腔总蛋白（≤45.3g/L，年龄校正 OR=27.7，95%可信区间：2.5，307.7）、胸腔乳酸脱氢酶（LDH，≤505U/L，年龄校正 OR=59.9，95%可信区间：4.2，857.2）和血尿素氮（≤3.2mmol/L，年龄校正 OR=32.0，95%可信区间：2.4，426.9）等变量与儿童胸腔 TB 诊断时胸腔 ADA 结果阴性相关。
我们的研究结果表明，胸痛、胸腔总蛋白、胸腔 LDH 和血尿素氮与儿童胸腔 TB 胸腔 ADA 结果阴性相关。在解释具有这些特征的儿童胸腔 ADA 水平时，需要对胸腔 TB 诊断进行仔细的临床评估。
