血清腺苷脱氨酶在急性白血病临床检验中的辅助诊断价值  

The Auxiliary Diagnostic Value of Serum Adenosine Deaminase in Acute Leukemia at Clinical Test

作　　者：刘沛 杨春梅[1] 叶宁 董世雷[1] 李萌[1] LIU Pei;YANG Chun-Mei;YE Ning;DONG Shi-Lei;LI Meng(Department of Clinical Laboratory Examination,Zhejiang Hospital,Hangzhou 310000,Zhejiang Province,China)

机构地区：[1]浙江医院医学检验科,浙江杭州310000

出　　处：《中国实验血液学杂志》2021年第4期1119-1122,共4页Journal of Experimental Hematology

基　　金：国家自然科学基金青年科学基金项目(81801978)。

摘　　要：目的:探讨血清中腺苷脱氨酶(ADA)在急性白血病(AL)临床检验中的辅助诊断价值。方法:选取2018年11月至2020年3月于浙江医院住院治疗的AL患者123例作为观察组,随机选取同期体检的健康者98例作为对照组。将AL患者分为两组:急性髓系白血病(AML)患者77例和急性淋巴细胞白血病(ALL)患者46例。检测各组患者血清中的腺苷脱氨酶(ADA)、谷丙转氨酶(ALT)、谷草转氨酶(AST)、谷氨酰转肽酶(GGT)、乳酸脱氢酶(LDH)和同型半胱氨酸(Hcy)的水平,并分析ADA与它们的相关性。采用受试者工作特征曲线(ROC)分析ADA的临床诊断价值,约登指数法确定最佳截点。结果:AL患者血清ADA水平显著高于对照组(P<0.05);Pearson相关性分析结果显示,AML组患者血清ADA与Hcy、ALT、AST、GGT、LDH呈显著正相关(r=0.47, r=0.28, r=0.37,r=0.22, r=0.55);ALL组患者血清ADA与GGT呈显著正相关(r=0.54)。AML组ROC曲线下最大面积为0.761(P=0.00),95%可信区间为0.682-0.841,敏感度为54.50%,特异性为98.90%,最佳截点为17.1 U/L。ALL组ROC曲线下最大面积为0.785,95%可信区间为0.694-0.877,敏感度为65.90%,特异性为84.00%,最佳截点为13.45 U/L。结论:检测血清中的ADA可以作为AL患者的一项辅助检查,对疾病的诊断有一定的价值。Objective: To investigate the auxiliary diagnostic value of serum adenosine deaminase(ADA) in acute leukemia(AL) at clinical test. Methods: 123 AL patients hospitalized in Zhejiang hospital from November 2018 to March 2020 were enrolled as the observation group, and 98 healthy people in the same period were randomly enrolled as the control group. AL patients were divided into two groups: 77 acute myeloid leukemia(AML) patients for AML group and 46 acute lymphoblastic leukemia(ALL) patients for ALL group. The levels of adenosine deaminase(ADA), alanine aminotransferase(ALT), aspartate aminotransferase(AST), glutamyl transpeptidase(GGT), lactate dehydrogenase(LDH) and homocysteine(Hcy) in serum of the patients were detected, and the correlation of ADA with these items was analyzed. Receiver operating characteristic curve(ROC) was used to analyze the clinical diagnostic value of ADA, Yoden index was used to confirm the best cut-off point. Results: The serum ADA level in AL patients was significant higher than that in control group(P < 0.05). The results of Pearson correlation analysis showed that there was a significant positive correlation of ADA with Hcy, ALT, AST, GGT, LDH in AML group(r = 0.47, r = 0.28, r = 0.37, r = 0.22, r =0.55);and also there was a significant positive correlation of ADA with GGT in ALL group(r = 0.54). In AML group,the maximum area under ROC curve was 0.761(P = 0.00), 95% confidence interval was 0.682-0.841, sensitivity was54.50%, specificity was 98.90%, and the best cut-off point was 17.1 U/L. In ALL group, the maximum area under ROC curve was 0.785, 95% confidence interval was 0.694-0.877, sensitivity was 65.90%, specificity was 84.00%, and the best cut-off point was 13.45 U/L. Conclusion: The detection of ADA in serum can be used as an auxiliary examination in patients with AL, which can provide a certain value for the diagnosis of the disease.

关 键 词：急性髓系白血病 急性淋巴细胞白血病 腺苷脱氨酶 辅助诊断 

分 类 号：R733.71[医药卫生—肿瘤]