ADA和有核细胞计数检测在感染性胸腔积液鉴别诊断中的价值  

Value of ADA and nucleated cell count in differential diagnosis of infectious pleural effusion

作　　者：钱堃[1] 赵磊 QIAN Kun;ZHAO Lei(the Fourth Affiliated Hospital of Anhui Medical University,Hefei,Anhui 230001,China)

机构地区：[1]安徽医科大学第四附属医院,安徽合肥230001

出　　处：《临床肺科杂志》2018年第9期1565-1568,共4页Journal of Clinical Pulmonary Medicine

摘　　要：目的探讨腺苷脱氨酶(adenosine deaminase,ADA)、有核细胞计数检测在结核性胸腔积液和类肺炎性胸腔积液鉴别诊断中的价值。方法筛选出2014年6月-2017年6月于我院呼吸内科就诊的78例感染性胸腔积液患者,其中结核性胸腔积液36例,类肺炎性胸腔积液42例。通过ROC曲线分析胸腔积液ADA水平、有核细胞计数对结核性胸腔积液、类肺炎性胸腔积液鉴别诊断效能。结果结核性胸腔积液组ADA高于类肺炎性胸腔积液组(P<0.05),ADA诊断结核性胸腔积液的敏感性为88.89%,特异性为88.10%(P<0.001);类肺炎性胸腔积液组有核细胞计数高于结核性胸腔积液组(P<0.001),有核细胞计数诊断类肺炎性胸腔积液敏感性为92.86%,特异性为83.33%(P<0.05);联合检测使鉴别诊断特异性显著提高。结论ADA、有核细胞计数分别对结核性胸腔积液、类肺炎性胸腔积液有较高的诊断效能,联合检测更有助于两者的鉴别诊断。Objective To explore the value of adenosine deaminase（ ADA） and nucleated cell count in the differential diagnosis of tuberculous pleural effusion and pneumonic pleural effusion. Methods 78 cases of infectious pleural effusion were selected in our hospital from June 2017 to June 2014,including 36 cases of tuberculous pleural effusion and 42 cases of pneumonic pleural effusion. ROC curve was used to analyze pleural effusion ADA level and nucleated cell count in differential diagnosis of tuberculous pleural effusion and pneumonic pleural effusion. Results The value of ADA in the tuberculous pleural effusion group was higher than that in the pneumonic pleural effusion group（ P〈0. 05）,the sensitivity of ADA to tuberculous pleural effusion was 88. 89%,and the specificity was88. 10%（ P〈0. 001）. The nuclear cell count in the pneumonic pleural effusion group was higher than that in the tuberculous pleural effusion group（ P〈0. 001）. The sensitivity and specificity of pleural effusion were 92. 86% and83. 33%,respectively（ P〈0. 05）. The combined detection made the specificity of differential diagnosis increased significantly. Conclusion ADA and nucleated cell counts have high diagnostic efficiency for tuberculous pleural effusion and pneumonic pleural effusion,and the joint detection is more helpful for the differential diagnosis.

关 键 词：结核性胸腔积液 类肺炎性胸腔积液 腺苷脱氨酶 有核细胞计数 

分 类 号：R52[医药卫生—内科学] R561.3[医药卫生—临床医学]