| 彭赛亮,赵年贵,何方方.胸水腺苷脱氨酶对结核性胸膜炎的诊断价值[J].济宁医学院学报,2019,42(5):360-362 |
| 胸水腺苷脱氨酶对结核性胸膜炎的诊断价值 |
| The diagnostic significance of pleural effusion adenosine deaminase in tuberculous pleurisy |
| 投稿时间：2019-09-01 |
| DOI：10.3969/j.issn.1000-9760.2019.05.012 |
| 中文关键词: 腺苷脱氨酶;结核性胸膜炎 |
| 英文关键词: Adenosine deaminase;Tuberculous pleurisy |
| 基金项目: |
| 作者 | 单位 | | 彭赛亮 | 厦门医学院附属第二医院, 厦门 361021 | | 赵年贵 | 厦门医学院附属第二医院, 厦门 361021 | | 何方方 | 厦门医学院附属第二医院, 厦门 361021 |
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| 中文摘要: |
| 目的 探讨胸水腺苷脱氨酶（Adenosine deaminase，ADA）与结核性胸膜炎的关系，评价胸水ADA检测对结核性胸膜炎的诊断价值。方法 回顾性分析我院2014年7月至2018年12月期间收治的结核性胸膜炎患者（病例组）和非结核性胸膜炎患者（对照组）胸水的ADA水平（使用氧化酶法检测系统），比较不同组别胸水ADA的差异，绘制受试者工作曲线（ROC）并计算多项性能评价指标，评价其对结核性胸膜炎的诊断效能，确定本检测系统检测胸水ADA用于诊断结核性胸膜炎的最佳cut off值。结果 病例组胸水ADA值（37.37±13.06） U/L，对照组胸水ADA值为（16.05±26.08） U/L，两组差异有统计学意义（P<0.01）；ROC曲线分析显示ADA对诊断结核性胸膜炎有较大价值，ROC曲线下面积（AUC）为0.882，95%CI（0.824，0.941），最佳cut off值=19.5，Sen=0.881，Spe=0.833，准确度=0.843，约登指数=0.689，PPV=0.809，NPV=0.883，诊断比值比为32。结论 胸水ADA测定是一项方便、快速和有效的结核性胸膜炎筛查诊断指标，本检测系统用于结核性胸膜炎筛查的最佳cut off值为19.5U/L。 |
| 英文摘要: |
| Objective To investigate the association between pleural effusion adenosine deaminase(ADA) and tuberculous pleurisy,and thus to evaluate the value of pleural ADA in the diagnosis of tuberculous pleurisy.Methods The ADA levels of pleural effusion detected by oxidase detection system in the patients with tuberculous pleurisy(the case group) and the patients with non-tuberculous pleurisy(the control group)admitted to our hospital from July 2014 to December 2018 were retrospectively analyzed and compared.The ROC was drawn to calculate a series of performance evaluation indexes which were used to assessed the diagnostic efficiency of pleural ADA and further determine the best cut-off value of pleural ADA detected by this detection system for the diagnosis of tuberculous pleurisy.Results The pleural ADA level of the case group(37.37±13.06 U/L)showed significant difference from that of the control group(16.05±26.08 U/L,P<0.01).The ROC analysis indicated that pleural ADA was valuable for the diagnosis of tuberculous pleuritis,which was reflected in following indexes:AUC(0.882),95%CI (0.824,0.941) and the best cut-off value(19.5),Sen(0.881),Spe(0.833),accuracy(0.843),Youden index(0.689),PPV(0.809),NPV(0.883) and OR(32).Conclusion The pleural fluid ADA is a convenient,rapid and effective marker for screening diagnosis of tuberculous pleurisy.The best cut-off value for the tuberculosis pleurisy screening is 19.5 U/L for this detection system. |
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