Adenosine deaminase isoenzymes estimation - as a diagnostic tool for tuberculous pleural effusions  

作　　者：Nalla NK Prasad CE Gopalakrishniah V Somayajulu VL Lakshmi K Chelluri 

机构地区：[1]Gandhi Medical College,Musheerabad,Hyderabad 500020(A.P),India [2]Stem Cell Lab,Global Hospitals,Lakdi-Ka-Pool,Hyderabad 500004(A.P),India

出　　处：《Asian Pacific Journal of Tropical Medicine》2009年第5期61-65,共5页亚太热带医药杂志（英文版）

摘　　要：Objective:To assess the efficacy of ADA isoenzyme estimation over that of total ADA level in pleural fluid and serum as a more efficient diagnostic indicator in tuberculous pleural effusions in high prevalence country like India.Methods:The efficacy was analysed in total thirty four patients of pleural effusions.Total ADA was estimated by Guitsi and Galanti Calorimetric method and ADA isoenzymes with and without EHNA[Erythro-9-（2- hydroxy-3-nonyl） adenine]a potent ADA₁ inhibitor using the same method.Results:The results demonstrated a statistically significant values of ADA₂ in serum（P【0.001）,pleural fluid（P = 0.000） and significant value for the ratio of pleural fluid ADA₂/serum ADA2（P【0.001） and pleural fluid ADA/ADA(₂（P【0. 005）.The sensitivity and specificity values of pleural fluid ADA|2 is 81.8%and 91.6%（cut off value 60 IU/L for Tuberculous effusions）,serum ADA₂ 95.4%and 66%（cut off value 70 IU/L for tuberculous effusions）. ADA2is an isoenzyme,which is significantly raised in tuberculous pleural effusions both in the serum and pleural fluid.Conclusion:Estimation of ADA isoenzymes is redundant as a diagnostic aid over total ADA estimation in view of the limited improvements both in specificity and sensitivity patterns and also in term of cost-benefit ratio.Objective:To assess the efficacy of ADA isoenzyme estimation over that of total ADA level in pleural fluid and serum as a more efficient diagnostic indicator in tuberculous pleural effusions in high prevalence country like India.Methods:The efficacy was analysed in total thirty four patients of pleural effusions.Total ADA was estimated by Guitsi and Galanti Calorimetric method and ADA isoenzymes with and without EHNA[Erythro-9-(2- hydroxy-3-nonyl) adenine]a potent ADA_1 inhibitor using the same method.Results:The results demonstrated a statistically significant values of ADA_2 in serum(P<0.001),pleural fluid(P = 0.000) and significant value for the ratio of pleural fluid ADA_2/serum ADA2(P<0.001) and pleural fluid ADA/ADA(_2(P<0. 005).The sensitivity and specificity values of pleural fluid ADA|2 is 81.8%and 91.6%(cut off value 60 IU/L for Tuberculous effusions),serum ADA_2 95.4%and 66%(cut off value 70 IU/L for tuberculous effusions). ADA2_ is an isoenzyme,which is significantly raised in tuberculous pleural effusions both in the serum and pleural fluid.Conclusion:Estimation of ADA isoenzymes is redundant as a diagnostic aid over total ADA estimation in view of the limited improvements both in specificity and sensitivity patterns and also in term of cost-benefit ratio.

关 键 词：Adenosine DEAMINASE ISOENZYMES TUBERCULOUS PLEURAL EFFUSIONS 

分 类 号：R521.7[医药卫生—内科学]