Fijałkowska A, Szturmowicz M, Tomkowski W, Burakowski J, Kober J, Filipecki S, Sakowicz A, Kwiek S
Kliniki Chorób Wewnetrznych, Instytut Gruźlicy i Chorób Płuc w Warszawie.
Pneumonol Alergol Pol. 1996;64 Suppl 2:174-9.
The diagnosis of tuberculous pericarditis is difficult. The cultures of the pericardial fluid for M.tuberculosis are often negative. The determination of ADA activity in pleural fluid in TB patients /PTS/ is very useful. It seemed reasonable to measure ADA activity in pericardial effusion. ADA activity in pericardial fluid of 40PTS/19 women and 21 men/with large pericardial effusion of different etiologies who were treated in our institute in years 1988-1995 was investigated. The median age was 44 years. In each case the pericardiocentesis was performed. PTS were grouped as follows: group I-4 PTS with strongly suspected TB pericarditis, group II-32 PTS with malignancy and group III-4 PTS with miscellaneous diseases. In group I the mean ADA activity was 24U/I(3-60), in group II 18U/I (3-60) and in group III 18U/I (0-37) (with a cutoff value for ADA activity of 40U/I). It was definitive bacteriologic diagnosis of TB pericarditis in PTS of group I. Our observation does not confirm the earlier data about the high ADA activity in clinically suspected TB pericarditis without bacteriologic diagnosis. The value of ADA determination in pericardial fluid is its high specificity (97%) in excluding of TB etiology of pericardial effusion.
结核性心包炎的诊断较为困难。结核分枝杆菌心包积液培养结果常为阴性。检测结核病患者（PTS）胸腔积液中的ADA活性非常有用。因此，测定心包积液中的ADA活性似乎是合理的。我们对1988年至1995年在我院接受治疗的40例PTS（19名女性和21名男性）心包大量积液且病因各异患者的心包积液ADA活性进行了研究。患者年龄中位数为44岁。所有患者均接受了心包穿刺术。PTS分为以下几组：第一组为4例高度疑似结核性心包炎患者；第二组为32例恶性肿瘤患者；第三组为4例患有其他疾病的患者。第一组ADA平均活性为24U/I（3 - 60），第二组为18U/I（3 - 60），第三组为18U/I（0 - 37）（ADA活性临界值为40U/I）。第一组患者经细菌学确诊为结核性心包炎。我们的观察结果并未证实早期关于临床疑似结核性心包炎但未经细菌学诊断时ADA活性较高的数据。心包积液ADA检测的价值在于其在排除心包积液结核病因方面具有较高的特异性（97%）。
