腺苷脱氨酶在结核性胸膜炎和恶性胸腔积液的对比临床分析

目的：探究腺苷脱氨酶在结核性胸腔积液和恶性胸腔积液中的含量规律。方法：回顾分析自2010年3月至2012年5月于本院胸心外科住院的胸腔积液患者，对穿刺获得的胸腔积液，用比色法测定胸腔积液中腺苷脱氨酶的水平。测量血中腺苷脱氨酶的水平进行对比。结果：结核性胸膜炎组患者胸腔积液ADA测定值为89．67±47．85IU／L，癌性胸腔积液组水平为24．56±11．491U／L，胸腔积液ADA水平在结核性胸膜炎与癌性胸腔积液组之间存在显著性差异（P〈0．05）；以ADA〉45IU／L诊断结核性胸膜炎：则敏感性为（48／51）94．1，特异性为（48／52）88．9％，以ADA〈45IU／L一诊断恶性胸腔积水：则敏感性（（51／55）89．4％，特异性为（51／54）94．4％；结核性胸膜炎中胸腔积液ADA／血清中ADA比值为2．25±0．72，癌性胸腔积液组水平0．43＋0．1，结核性胸膜炎与癌性胸腔积液组之间存在显著性差异（P〈0．05）；以胸腔积液ADA／血清中ADA比值〉1．0为界诊断结核性胸膜炎：则敏感性为（46／51）90．1，特异性为（45／55）81．8．％，以胸腔积液ADA／血清中ADA比值〈1．0诊断恶性胸腔积水：则敏感性（47／57）82．4％，特异性为（47／53）88．7％。结论：腺苷脱氨酶在结核性胸膜炎和恶性胸腔积液中的含量有明显差异。

Adenosine Deaminase in Malignant Pleural Effusion and Tuberculous Pleuritis Clinical Contrast Analysis

Objective： To explore the regular of adenosine deaminase content in tuberculous pleural effusion and malignant pleural effusion. Methods： From March 2010 to May 2012, chest cardiac pleural effusion patients in our hospital were Retrospectively analyzed. The pleural effusion by puncture was determined by colorimetric method of adenosine deaminase levels. Measurement of serum adenosine deaminase levels were compared. Results： Tuberculous pleurisy group of patients with pleural effusion ADA measurement value was 89.67, 47, 85 iu/L, cancerous pleural effusion group level was 24. 56±11.49 iu/L, pleural effusion ADA levels with cancerous pleural effusion in tuberculous pleurisy there was significant difference between groups （P 〈 0.05）; to ADA 〉 _45 IU/L diagnosis of tuberculous pleurisy： sensitivity to 94.1 （48/51）, specificity of 88.9% （48/52）, with ADA 〈 45 IU/L a diagnosis of malignant pleural effusion： the sensitivity （89.4% （51/55）, specificity of 94.4% （51/54）, pleural effusion in tuberculous pleurisy ADA/serum ADA ratio 2.25 and 0.72, cancerous pleural effusion group level was 0.43 and 0.1, tuberculous pleurisy and there was significant difference between cancerous pleural effusion group （P 〈 0.05）; to ADA in pleural effusion ADA/serum ratio 〉 1.0 was bounded in the diagnosis of tuberculous pleurisy： sens- itivity to 90.1 （46/51）, specificity （45/55） for 81.8. %, ADA/serum ADA in pleural effusion ratio 〈 1.0 in the diagnosis of malignant pleural effusion： sensitivity 82.4% （47/57）, specificity （88.7% （47/53））. Conclusion： The content of adenosine deaminase in malignant pleural effusion and tuberculous pleurisy have obvious difference.