胸腔积液腺苷脱氨酶诊断结核性胸膜炎价值评估  

Evaluation of value of adenosine deaminase in diagnosing tuberculous pleurisy

作　　者：李丽[1] 赵勇[1] 何正光[1] LI Li;ZHAO Yong;HE Zhengguang(Department of Respiration,Suining Municipal Central Hospital,Suining,Sichuan 629000,China)

机构地区：[1]遂宁市中心医院呼吸中心,四川629000

出　　处：《现代医药卫生》2020年第7期982-984,988,共4页Journal of Modern Medicine & Health

摘　　要：目的探讨胸腔积液腺苷脱氨酶(ADA)诊断结核性胸膜炎(TPE)的价值及最佳临界值。方法回顾性分析2013年1月至2018年12月该院收治的375例经胸膜病理活检确诊为TPE患者(236例)和非结核性胸腔积液患者(139例)胸腔积液ADA水平,同时分析影响ADA水平的相关因素,应用受试者工作特征曲线确定胸腔积液ADA诊断TPE的最佳临界值。结果TPE患者胸腔积液ADA水平明显高于非结核性胸腔积液患者,差异有统计学意义(P<0.05);不同性别、年龄TPE患者ADA水平比较,差异均无统计学意义(P>0.05);胸腔积液ADA诊断TPE的最佳临界值为22.2 U/L,灵敏度和特异性分别为93.64%、85.61%。结论胸腔积液ADA可很好地鉴别TPE与非结核性胸腔积液,将ADA临界值设为22.2 U/L时诊断TPE的效果最佳。Objective To investigate the value and optimal critical value of adenosine deaminase(ADA)in diagnosing tuberculous pleural effusions(TPE).Methods The ADA level in pleural effusion of 375 patients with TPE and non TPE confirmed by pleural biopsy pathology treated in the hospital from January 2013 to December 2018 were analyzed retrospectively,meanwhile the related factors affecting ADA level were analyzed.The receiver operation characteristic(ROC)curve was used to determine the optimal critical value of ADA level in pleural effusion of TPE patients.Results The ADA level in pleural effusion of TPE patients was significantly higher than that in the patients with non-TPE,and the difference was statistically significant(P<0.05).However,there was no statistically significant difference in the ADA level between different sexes and among different ages(P>0.05).The cutoff value of pleural effusion ADA for diagnosing TPE was 22.2 U/L,its sensitivity and specificity were 93.64%and 85.61%respectively.Conclusion The ADA value in pleural effusion can better differentiate TPE pleural effusion from non-TPE pleural effusion.When the ADA cutoff value is set at 22.2 U/L,the effect for diagnosing TPE is the best.

关 键 词：结核 胸膜/诊断 胸腔积液 腺苷脱氨酶 ROC曲线 

分 类 号：R521.7[医药卫生—内科学] R446[医药卫生—临床医学]