胸水ADA并结核菌试验诊断结核性胸膜炎80例临床分析

摘要

Objective: To observe the value of pleural fluid adenosine deaminase ( ADA ) detection combined with TB test to diagnose tuberculous pleurisy. Method: 80 patients with tuberculous pleurisy treated in our hospital from Jan. 2008 to Dec. 2010 were selected, and 80 healthy patients during the same period were selected for the control. And all the patients were given detection of pleural fluid adenosine deaminase ( ADA ) and determination of TB-DNA. Detection of pleural fluid adenosine deaminase ( ADA ) applied enzymatic method for continuous monitoring method, while determination of TB-DNA took PCR method. Analyzing the sensitivity and specificity of pleural fluid adenosine deaminase ( ADA ) detection combined with TB test to diagnose tuberculous pleurisy. Result: The sensitivity and specificity of pleural fluid adenosine deaminase ( ADA ) detection combined with TB test to diagnose tuberculous pleurisy was respectively 87. 50% and 88. 75%. The sensitivity and specificity of TB-DNA detection to diagnose tuberculous pleurisy was respectively 71. 25% and 83. 75%. And the sensitivity and specificity of pleural fluid adenosine deaminase ( ADA ) detection combined with TB test to diagnose tuberculous pleurisy was respectively 92. 50% and 93. 75% . Conclusion: Pleural fluid adenosine deaminase combined with TB test can improve evidently the sensitivity and specificity of diagnosing tuberculous pleurisy and improve the diagnostic efficiency.%目的:探讨胸水腺苷脱氨酶(ADA)检测联合结核菌试验对结核性胸膜炎的诊断价值.方法:选择我院2008年1月至2010年12月收治的80例结核性胸膜炎患者与同期80例健康体检者为对照,对其进行胸水腺苷脱氨酶(ADA)检测与TB-DNA含量测定.胸水腺苷脱氨酶(ADA)检测采用酶法连续监测法,而TB-DNA含量测定采用PCR法,分析胸水腺苷脱氨酶(ADA)检测联合结核菌试验对诊断结核性胸膜炎的灵敏度与特异性.结果:胸水ADA检测对诊断结核性胸膜炎灵敏度为87.50%,特异性为88.75%;TB-DNA检测对诊断结核性胸膜炎灵敏度为71.25%,特异性为83.75%;胸水ADA联合TB-DNA检测对诊断结核性胸膜炎灵敏度为92.50%,特异性为93.75%.结论:胸水腺苷脱氨酶联合结核菌试验可显著提高诊断结核性胸膜炎的灵敏度和特异性,提高诊断效率.