腺苷脱氨酶同工酶在结核性胸积液和肿瘤性胸积液的诊断价值研究  

Diagnostic value of adenosine deaminase isoenzyems in tuberculous pleurisy and carcinomatous pleurisy

作　　者：李方知[1] 黄广雄[1] 

机构地区：[1]广东省广州市胸科医院急诊科,510095

出　　处：《检验医学与临床》2009年第20期1719-1720,共2页Laboratory Medicine and Clinic

摘　　要：目的探讨腺苷脱氨酶(ADA)同工酶(ADA1和ADA2)活性检测在结核性胸积液和肿瘤性胸积液的鉴别诊断意义。方法收集36例结核性胸积液和28例肿瘤性胸积液为研究对象,检测结核性胸积液和肿瘤性胸积液的总ADA和ADA2活性,比较两组胸积液的总ADA和ADA2活性区别在鉴别诊断的意义。结果结核性胸积液组的总ADA、ADA2活性显著高于肿瘤性胸积液组(P<0.01)。在诊断结核性胸膜炎上,总ADA的敏感性和特异性分别为83.3%和92.86%;ADA2的敏感性和特异性分别为83.3%和96.4%。在诊断肿瘤性胸膜炎上,总ADA的敏感性和特异性分别为92.8%和81.2%,ADA2的敏感性和特异性分别为96.4%和81.8%。结论检测胸积液总ADA和ADA2活性可为结核性胸积液和肿瘤性胸积液的鉴别诊断提供有效参考,检测ADA2活性优于总ADA活性。Objective To investigate the differential diagnostic significance of examination of adenosine deaminase （ADA） isoenzymes activity （ADA2） in tuberculous pleurisy and carcinomatous pleurisy. Methods Thirty-six tuberculous effusions from the patients with confirmed tuberculosis were examined, twenty-eight carcinomatous effusions from the patients with confirmed cancer were examined with total ADA and ADAe activity. Results Total ADA and ADA2 activity in tuberculous pleurisy was hihger than that in carcinomatous pleurisy（P〈0.01）. The sensitive diagnosis of tuberculous pleurisy was 83.3% by ADA, the specitive diagnosis of tuberculous pleurisy was 92. 86% by ADA. The sensitive diagnosis of tuberculous pleurisy was 83.3% by ADA2, the specitive diagnosis of tuberculous pleurisy was 96.43% by ADA2. Conclusion Total ADA and ADA2 activity could be used as valuable parameters for the differentiation of tuberculous effusion from carcinomatous pleurisy.

关 键 词：胸积液 腺苷脱氨酶同工酶 结核 

分 类 号：R446.61[医药卫生—诊断学] R521.704[医药卫生—临床医学]