胸水和血清ADA、TB-Ab-IgG联合检测对结核性胸膜炎的诊断探讨  

The diagnostic value of pleural effusion combined with serum ADA and TB-Ab-IgG on testing pleural tuberculosis

作　　者：杨晓梅[1] 钟兰[1] 

机构地区：[1]重庆市肺科医院,重庆400020

出　　处：《临床肺科杂志》2012年第5期851-852,共2页Journal of Clinical Pulmonary Medicine

摘　　要：目的探讨胸水/血清腺苷脱氨酶(ADA)、结核抗体(TB-Ab-IgG)联合检测对结核性胸膜炎的诊断价值。方法采用斑点金免疫渗滤试验(DIGFA)和酶连续监测法对234例胸腔积液进行胸水/血清ADA和TB-Ab-IgG检测结果进行分析。结果结核性胸膜炎患者174例其胸水、血清中TB-Ab-IgG的阳性率分别为62.0%和70.1%,特异性分别为93.1%(56/60)和86.6%(52/60)。ADA活性在结核性和癌性胸腔积液中分别为(59.58±29.85)U/L和(15.31±7.36)U/L(P<0.01)。以P-ADA>40 U/L做为诊断结核的临界值,其敏感性为79.3%,特异性为86.4%;以P-ADA/S-ADA>1为临界值,其敏感性为97.7%,特异性为95.5%。结论胸水和血清ADA、TB-Ab-IgG联合检测在结核性胸膜炎与非结核性胸膜炎上具有诊断与鉴别诊断价值。Objective To study the diagnostic value of detection of Pleural effusion and serum deaminase（ADA） and antibody to mycobacterium tuberculosis（TB-Ab-IgG） in pleural tuberculosis.Methods The TB-Ab-IgG levels were detected by dot immunogold filtration assay（DIGFA）,and The（ADA） levels were detected by continuous monitored enzymatic method in 234 samples of pleural exudates and serum.Results The sensitivity of TB-Ab-IgG in pleural effusion and serum of 174 patients with pleural tuberculosis was 62.0% and 70.1%,respectively,and the specificity was 93.1% and 86.6%,respectively.The ADA acttivty of tuberculous and malignant effusion was 52.51% and 10.26% U/L,with a significant difference（P0.01）.If the critical value of ADA was40 U/L in tuberculosis diagnosis,its sensitivity was 79.3% and specificity was 86.6%,If the critical value of Pleural effusion ADA/serum ADA was1.00 in tuberculosis diagnosis,its sensitivity was 97.7% and specificity was 96.6%.Conclusion The detection of ADA and TB-Ab-IgG of pleural effusion and serum is of great value in differentiating tuberculous pleuritis from nontuberculous pleuritis.

关 键 词：腺苷脱氨酶(ADA) 结核抗体(TB-Ab) 胸腔积液 结核性胸膜炎 

分 类 号：R521.7[医药卫生—内科学]