Fielli Mariano, Gonzalez Alejandra, Heres Marcela, Carreño Saavedra Ruth, Asquineyer Yanina, Benitez Rosalia
Servicio de Neumonología, Hospital Nacional Profesor Alejandro Posadas, Provincia de Buenos Aires, Argentina.
Servicio de Neumonología, Hospital Nacional Profesor Alejandro Posadas, Provincia de Buenos Aires, Argentina. E-mail:
Medicina (B Aires). 2021;81(6):954-957.
The determination of adenosine deaminase (ADA) is useful in countries where the prevalence of tuberculosis (TB) is high/ moderate. The objective of this study was to analyze the cut-off point for ADA in patients with TB at our institution. All patients with pleural effusion were included, from May 2016 to March 2019, except those with positive serology for HIV and transudates. They were grouped into the following diagnoses: TB, neoplasm, parapneumonic or other with an unclear cause. ADA determination and culture for mycobacteria were performed on all samples of pleural fluid. A ROC curve was performed to establish the best ADA cut-off point for the diagnosis of TB. Information was collected from 309 patients; 220 were included and 87 had a diagnosis of TB. The best cut-off point obtained for ADA was 52 U/l, with a sensitivity of 79% and a specificity of 90%. The area under the curve (AUC) was 0.90. In patients under 40 years old the best cut-off point was 41 U/l, below that obtained for the total study population. In our population the cut-off point for the ADA value in pleural exudate for the diagnosis of tuberculosis of 52 U/l presents the highest specificity and sensitivity.
在结核病（TB）患病率高/中等的国家，腺苷脱氨酶（ADA）的测定很有用。本研究的目的是分析我院结核病患者ADA的临界值。纳入了2016年5月至2019年3月所有胸腔积液患者，但排除了HIV血清学阳性和漏出液患者。他们被分为以下诊断类别：结核病、肿瘤、类肺炎性或病因不明的其他疾病。对所有胸腔积液样本进行ADA测定和分枝杆菌培养。绘制ROC曲线以确定诊断结核病的最佳ADA临界值。收集了309例患者的信息；纳入220例，其中87例诊断为结核病。ADA获得的最佳临界值为52 U/l，敏感性为79%，特异性为90%。曲线下面积（AUC）为0.90。40岁以下患者的最佳临界值为41 U/l，低于整个研究人群的临界值。在我们的人群中，胸腔渗出液中ADA值诊断结核病的临界值为52 U/l时具有最高的特异性和敏感性。
