胸水和血清中的腺苷脱氨酶、乳酸脱氢酶水平及其比值在结核性胸膜炎诊断中的价值

摘要

目的：探讨胸水与血清中的腺苷脱氨酶（ADA）与乳酸脱氢酶（LDH）的含量及其比值在结核病诊断中的价值。方法随机抽取2014年上半年该院收治的结核性胸膜炎患者50例（结核组），肝性胸水（对照组）20例，进行胸水和血清的 ADA、总蛋白（TP）、LDH 测量，计算其相应的比值，并绘画 ROC 曲线。计算 ADA 和 LDH 在诊断结核性胸膜炎的敏感性、特异性和准确性。结果结核组中 ADA、TP、LDH 含量及其比值明显高于对照组，差异显著有统计学意义（P ＜0．05）。结核组胸水中的ADA 联合 LDH 诊断敏感度、特异度和准确度分别为82．0％，94．0％和88．0％。联合检测的敏感度和准确度均高于任一单项检测。结论胸水与血清中的 ADA 与 LDH 及其比值在结核胸膜炎诊断中具有重要临床价值。%Objective To investigate the value of levels and the ratio of adenosine deaminase and lactate dehydrogenase in ascites and serum in the diagnosis of tuberculous pleurisy.Methods We randomly extracted fifty cases of tuberculous pleurisy patients (tuberculo-sis group)and twenty cases of hepatic hydrothorax (control group)treated in our hospitals in the first half of 2014,then measured the ADA,total protein (TP),LDH in ascites and serum and calculated the corresponding ratio and drew the ROC curve.The sensitivity, specificity and accuracy of ADA and LDH in the diagnosis of tuberculous pleurisy was caculated.Results The levels of ADA,TP,LDH in the tuberculosis group and the ratio of the ascites and serum were significantly higher than the control group.The difference was sta-tistically significant (P <0.05).The sensitivity,specificity and accuracy of ADA and LDH were 82.0%,94.0% and 88.0%,respec-tively,and the sensitivity and accuracy of the combined detection were higher than any single one.Conclusions The levels of ADA and LDH and the ratio in ascites and serum has important clinical value in diagnosing tuberculous pleurisy.