胸水腺苷脱氨酶结合ROSE技术在结核性胸膜炎诊断中的应用  

Application of ADA of pleural fluid combined with ROSE technique in the diagnosis of tuberculous pleurisy

作　　者：梁亚充 李晓倩 韩朝[2] 池跃朋[1] 马丽 王国卫[4] LIANG Ya-chong;LI Xiao-qian;HAN Chao(The Second Department of Tuberculosis,Hebei Chest Hospital,Shijiazhuang 050041,China;不详)

机构地区：[1]河北省胸科医院结核二科,河北石家庄050041 [2]河北省胸科医院结核二科眼科,河北石家庄050041 [3]河北省胸科医院结核二科体检中心,河北石家庄050041 [4]河北省胸科医院结核二科中医科,河北石家庄050041

出　　处：《中国医学装备》2021年第2期62-66,共5页China Medical Equipment

基　　金：河北省医学科学研究课题计划(20190995)“快速现成评价(ROSE)联合胸膜活检在结核性胸膜炎诊断中的运用”。

摘　　要：目的:探讨胸水腺苷脱氨酶(ADA)联合快速现场评价(ROSE)技术在结核性胸膜炎诊断中的应用。方法:选取100例疑似结核性胸膜炎患者作为研究对象,依据诊断结果的不同将其分为结核性胸膜炎组(39例)和非结核性胸膜炎患者组(61例)。纳入研究者均采用全自动生化分析仪行胸水ADA(PADA)和血清ADA(SADA)水平检测,ROSE技术检测诊断结核性胸膜炎,受试者工作特征(ROC)曲线评价胸水ADA联合ROSE技术、单独ROSE技术对结核性胸膜炎的诊断价值。结果:结核性胸膜炎组与非结核性胸膜炎组相比,胸水中PADA、PADA/SADA降低(t=127.108,t=25.570;P<0.05),SADA水平升高(t=5.287,P<0.05),ROSE技术检测结核性胸膜炎组阳性、阴性比例差异有统计学意义(x^(2)=28.125;P<0.05)。ROSE诊断结核性胸膜炎,真阳性30例,假阴性9例,假阳性14例,真阴性47例。灵敏度为76.92%,特异度为77.05%,准确度为77.00%。胸水中ADA联合ROSE诊断结核性胸膜炎,真阳性36例,假阴性3例,假阳性3例,真阴性58例。灵敏度为92.31%,特异度为95.08%,准确度为94.00%。胸水中ADA联合ROSE诊断与ROSE单独诊断结核性胸膜炎相比,结核性胸膜炎特异度、准确度升高(x^(2)=8.270,x^(2)=11.656;P<0.05);联合诊断的曲线下面积升高,两种诊断方法比较差异有统计学意义(Z=4.355,P<0.05)。结论:ROSE技术和胸水ADA联合ROSE技术对结核性胸膜炎均有一定的诊断价值,但胸水ADA联合ROSE技术对结核性胸膜炎的诊断价值更高,可为结核性胸膜炎的诊断提供参考。Objective:To explore the application of adenosine deaminase(ADA)of pleural fluid combined with rapid on site evaluation(ROSE)technique in the diagnosis of tuberculous pleurisy.Methods:100 patients with suspected tuberculous pleurisy were selected as the study objects,and they were divided into tuberculous pleurisy group(39 cases)and non-tuberculous pleurisy group(61 cases)according to differently diagnostic results.The levels of pleural effusion ADA(PADA)and serum ADA(SADA)of the patients were detected by full automatic biochemical analyzer,and ROSE technique was used to detect and confirm tuberculous pleurisy,and receiver operating characteristic(ROC)curve was used to evaluate the diagnostic values of ADA combined with ROSE technique and single ROSE technique in tuberculous pleurisy.Results:Compared with non-tuberculous pleurisy group,PADA and PADA/SADA of pleural fluid of tuberculous pleurisy group significantly decreased(t=127.108,t=25.570,P<0.05),and the level of SADA significantly increased(t=5.287,P<0.05),and the difference of the positive and negative proportions of tuberculous pleurisy group that was detected by ROSE technique was significant(x^(2)=28.125,P<0.05).In the diagnosis of ROSE for tuberculous pleurisy,30 cases were true positive,and 9 cases were false negative,and 14 cases were false positive and 47 cases were true negative.The sensitivity,specificity and accuracy of that were 76.92%,77.05%and 77.00%,respectively.In the diagnosis of ADA of pleural fluid with ROSE for tuberculous pleurisy,36 cases were true positive,and 3 cases were false negative,and 3 cases were false positive,and 58 cases were true negative.The sensitivity,specificity and accuracy were 92.31%,95.08%and 94.00%.Compared with the single ROSE diagnosis for tuberculous pleurisy,the specificity and accuracy of ADA of pleural fluid combined with ROSE in diagnosing tuberculous pleurisy were significantly increased(x^(2)=8.270,x^(2)=11.656,P<0.05),and the area under the curve(AUC)of combined diagnosis was significantly increased(Z=4.3

关 键 词：胸水 腺苷脱氨酶(ADA) 快速现场评价 结核性胸膜炎 诊断 

分 类 号：R561.1[医药卫生—呼吸系统]