目的 探讨血清腺苷脱氨酶(ADA)、乳酸脱氢酶(LDH)和C反应蛋白(CRP)联合检测在肺结核、肺炎、肺癌鉴别诊断中的应用价值.方法 收集本院呼吸科肺结核(36例)、肺炎(40例)及肺癌(40例)患者的血清样本,检测其ADA、LDH、CRP水平,并综合分析其意义.结果 肺结核患者的血清ADA水平为(55.12±13.85)U/L,显著高于肺炎患者的(19.41±4.91)U/L和肺癌患者的(24.32±4.12)U/L,差异均有统计学意义(P＜0.05);肺癌患者血清LDH水平为(445.31±8.31)U/L,显著高于肺炎患者的(113.21±47.31) U/L,但与肺结核患者比较无显著差异;肺炎患者血清CRP水平为(75.31±10.34) mg/L,显著高于肺癌患者的(43.12±8.65) mg/L和肺结核患者的(34.31±4.51)mg/L,差异均有统计学意义(P＜0.05).结论 血清ADA水平是肺结核患者的重要标志物,其与CRP联合检测可初步鉴别肺结核与肺炎.对于肺癌患者,单一血清学标志物并无显著特异性,若与肺结核进行鉴别时,需参考其他肿瘤标志物或辅助检查结果,或可通过血清ADA、LDH联合检测的方法进行鉴别.%Objective To investigate the joint detection value of serum adenosine deaminase (ADA),lactate dehydrogenase(LDH),C-reactive protein (CRP) levels in the differential diagnosis of tuberculosis,pneumonia and lung cancer.Methods Thirty-six cases with tuberculosis,forty cases with pneumonia,forty cases with lung cancer in the respiratory department of our hospital were collected and their serum samples were detected for ADA,LDH,CRP levels.Its significance was comprehensively analyzed.Results The serum ADA levels in tuberculosis patients were significantly higher than the pneumonia and lung cancer patients (55.12 ± 13.85 vs 19.41 ± 4.91,24.32 ± 4.12 U/L,P ＜ 0.05).Serum LDH levels in patients with lung cancer were significantly higher in patients with pneumonia (445.31 ± 89.31 vs 113.21 ± 47.31 U/L),with no significant difference (P ＞0.05) in patients with pulmonary tuberculosis.Serum CRP levels in patients with pneumonia were significantly higher than patients with lung cancer and tuberculosis (75.31 ± 10.34vs43.12±8.65,34.31±4.51 mg/L,P＜0.05).Conclusion Serum ADA level is an important marker of tuberculosis patients with CRP detection combined with the preliminary identification of tuberculosis and pneumonia.For lung cancer patients,a single serological marker has no significant specificity to identify tuberculosis.With reference to the results of other tumor markers or laboratory examinations,or by serum the ADA + LDH joint detection method,identification to tuberculosis is available.
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