支气管肺泡灌洗液腺苷脱氨酶检测在痰菌阴性肺结核诊断中的应用

摘要

Objective To study the clinical application value of adenosine deaminase(ADA) concentration detection in brocho-alveolar lavage fluid(BALF) in diagnosis of sputum bacterium negative TB.Methods ADA concentration in BALF in 64 patients with sputum bacterium negative TB and a TB group and a normal control group was detected in the same way, and mycobacterium tuberculosis in BALF was detected in R-J culture method and PCR method.The results were compared and ana-lyzed.Results ADA content of BALF in sputum bacterium negative TB patients was significantly higher than the non-TB group (t'=11.2587,t'α=1.9986,P <0.05),but with no statistical significance compared with sputum bacterium positive group.ADA positive rate of BALF in sputum bacterium negative TB group had no statistical significance compared with TB DNA PCR mothod,and was significantly higher than that by L-J culture method.Conclusion ADA concentration in BALF has high value to the diagnosis and differential diagnosis for sputum bacterium negative TB.It is a simple, effective, low cost and rapid method for clinical application.%目的：探讨支气管肺泡灌洗液中腺苷脱氨酶浓度对痰涂片抗酸杆菌阴性肺结核的诊断价值。方法64例菌阴肺结核患者和肺结核组、正常对照组的 BALF 同时检测 ADA、罗氏培养法和 PCR 法检测结核分枝杆菌，并比较分析。结果痰菌阴性的肺结核组患者 BALF 中的 ADA 含量明显高于非结核组（t＇＝11．2587，t＇α＝1．9986，P ＜0．05）；而与痰菌阳性组相比无统计学意义。菌阴肺结核 BALF 中 ADA 的阳性率与 TB DNA PCR 法比较无统计学意义，而显著高于罗氏培养法。结论对菌阴肺结核支气管肺泡灌洗液中 ADA 浓度进行测定有较高的诊断和鉴别诊断价值，是一种简单有效低廉快速的临床应用方法。