胸腔积液ADA、CRP和LAM-IgG联合检测的鉴别诊断价值  

Differential Diagnosis Value of Adenosine Deaminase,C-reactive Protein and Anti-Lipoarabinomannan Antibody for Pleural Effusions

作　　者：陈蕾[1] 闻平[1] 

机构地区：[1]江苏大学附属医院检验科,江苏镇江212001

出　　处：《现代检验医学杂志》2005年第4期23-25,共3页Journal of Modern Laboratory Medicine

摘　　要：目的探讨胸腔积液腺苷脱氨酶(ADA)、C反应蛋白(CRP)、阿拉伯糖甘露糖脂抗体(LAM-IgG)联合检测对良恶性胸腔积液鉴别诊断的意义。方法以氨试剂法、散射比浊法和金标渗滤法同时检测了48例结核性胸水、27例癌性胸水和31例非结核炎性胸水的ADA、CRP和LAM-IgG。结果结核性胸水ADA、CRP活性明显高于癌性胸水(P<0.01),其它炎性胸腔积液CRP含量明显高于结核性和恶性胸腔积液(P<0.01);以ADA>30u/L,CRP>8mg/L,及LAM-IgG阳性等单个指标来诊断结核性胸腔积液,其敏感性达到95.7%,特异性为98.1%;以ADA<30u/L,CRP<8mg/L,及LAM-IgG阴性等单个指标来诊断恶性胸腔积液,其敏感性达到98.7%,特异性为97.1%。结论ADA、CRP、LAM-IgG联合检测可为良恶性胸腔积液的鉴别诊断提供可靠的实验室依据。Objective To explore differential diagnosis value of adenosine deaminase （ADA）,C-reactive protein（CRP）and anti-lipoarabinomannan antibody （LAM-IgG）for pleura1 effusions, Methods ADA,CRP and LAM-IgG were detected using colormetric assay,nephelometric assay and dot immunogold filtration assay in 106 pleura1 effusions with tuberculosis,carcinoma of non-tuberculosis infection, Results ADA and LAM-IgG activity in tuberculous pleural effusions were higher than others significantly（P〈0. 01 ）,and CRP in non-tuberculous pleural effusions was significantly higher than in tuberculous pleura1 effusions. The sensitivity and specifity of ADA,CRP and LAM-IgG combination were 95.7% and 98. 1% for diagnosing tuberculous pleural effusions; 98.7% and 97.1% for diagnosing malignant pleural effusions. Conclusion ADA,CRP and LAM-IgG are useful parameters for differential diagnosis of pleural effusions.

关 键 词：结核性胸腔积液 恶性胸腔积液 腺苷脱氨酶 C反应蛋白 阿拉伯糖甘露糖脂抗体 诊断 

分 类 号：R561[医药卫生—呼吸系统] R446.62[医药卫生—内科学]