三种方法联合检测对结核性胸膜炎的诊断价值

目的探讨胸水和血清ADA(腺苷脱氨酶)联合胸水抗结核抗体检测对结核性胸水的诊断价值。方法对40例结核性胸腔积液和32例恶性胸腔积液患者血清ADA和胸水ADA以及胸水中抗结核抗体IgG进行检测。结果结核性胸腔积液抗结核抗体TB-Ab阳性率为65%,胸水ADA>45U/L者34例,阳性率85%,显著高于恶性胸腔积液组.差异具有显著性(P<0.05)。90%结核性胸膜炎患者胸水ADA/血清ADA比值>1.0。联合三种检测法敏感性及特异性可高达97.5%和96.88%。结论胸腔积液ADA水平和抗结核抗体检测联合胸水ADA/血清ADA比值的检测,对结核性胸膜炎的诊断有重要的临床价值,较单一测定胸水ADA可显著提高结核性胸膜炎的诊断率。

The Clinical Value of the Combined Three Methods in the Diagnosis of Tuberculous Pleurisy

Objective To study the diagnostic value of pleural effusion and serum ADA combined with pleural effusion tuberculosis antibody on testing tuberculous pleurisy. Methods To measure serum and pleural effusion ADA and TB-Ab in pleural effusion of all the patients(40 cases tuberculous pleural effusion,32 cases malignant pleural effusion). Results The positive rates of TB-Ab and ADA in tuberculous pleural effusion were 65% and 85%,which were significantly higher than those in the malignant group(P<0.05). The sensitivity and specificity of the combined three methods were 97.5% and 96.88%.These rate of combined method were obviously higher than those of the single test(P<0.01). Conclusion Pleural effusion ADA or TB-Ab and pleural/serum ADA ratio combined assay are more effective in diagnosing tuberculous pleurisy than single ADA determination.