Gratacós J, Vila J, Moyá F, Marcos M A, Collado A, Sanmartí R, Brancós M A, Jimenez de Anta M T, Muñoz-Gómez J
Department of Rheumatology, Hospital Clinic i Provincial, University of Barcelona, Spain.
J Rheumatol. 1995 Aug;22(8):1504-8.
To analyze the usefulness of D-lactic acid levels in synovial fluid (SF) as a rapid test to support the early diagnosis of bacterial arthritis (BA).
A simple modification of the enzyme method used for measuring L-lactic acid was used to analyze levels of D-lactic acid in SF from 20 cases of BA. Results were compared with those from 99 noninfectious arthritis, which included 90 inflammatory SF samples. Total white blood cell count (WBC), percentage of polymorphonuclears (% PMN) and gram stains were also determined.
D-lactic acid levels were significantly higher in BA than in noninfectious arthritis. Using a cutoff value of 0.05 mM, 85% of the SF samples from BA had a positive test for D-lactic acid compared with 4% of the control group. The overall sensitivity of the assay was 85% with a specificity of 96%, showing a positive predictive value for BA of 81% and a negative predictive value of 97%.
The data presented suggest that D-lactic acid is an accurate, easy test that can be carried out in any laboratory, to support the early diagnosis of BA.
分析滑液（SF）中D-乳酸水平作为支持细菌性关节炎（BA）早期诊断的快速检测方法的实用性。
采用一种用于测量L-乳酸的酶法的简单改良方法，分析20例BA患者滑液中的D-乳酸水平。将结果与99例非感染性关节炎患者（其中包括90例炎症性滑液样本）的结果进行比较。还测定了白细胞总数（WBC）、多形核白细胞百分比（%PMN）和革兰氏染色。
BA患者的D-乳酸水平显著高于非感染性关节炎患者。采用0.05 mM的临界值，85%的BA滑液样本D-乳酸检测呈阳性，而对照组为4%。该检测的总体敏感性为85%，特异性为96%，BA的阳性预测值为81%，阴性预测值为97%。
所提供的数据表明，D-乳酸是一种准确、简便的检测方法，可在任何实验室进行，以支持BA的早期诊断。
