降钙素原与腺苷脱氨酶联合检测对结核性胸腔积液的诊断价值

目的探讨联合检测血清和胸腔积液降钙素原（PCT）、腺苷脱氨酶（ADA）对结核性胸腔积液的诊断价值。方法 128例胸腔积液患者分为3组：结核性52例为结核组,肺炎旁积液22例为肺炎组,恶性40例和心衰性14例为对照组。测定各组患者血清和胸腔积液的PCT、ADA水平。结果结核组、肺炎组和对照组间血清PCT水平差异无统计学意义（P〉0.05）,结核组和肺炎组胸腔积液中PCT的表达均较对照组明显升高（均P〈0.05）。结核组血清和胸腔积液中ADA水平较肺炎组和对照组显著升高（P〈0.01）。受试者工作曲线（ROC曲线）分析胸腔积液ADA/血清ADA值（P/S值）〉1.27诊断结核性胸腔积液的敏感度和特异度最佳,分别为92.3%和100%。结论联合检测胸腔积液中PCT与ADA的表达可极大提高结核性胸腔积液诊断的敏感性和特异性。

The Diagnostic Value of Procalcitonin, Adenosine Deaminase for Tuberculous Pleural Effusions

Objective To explore differential diagnostic value of procalcitonin（PCT）,adenosine deaminase（ADA） in pleural fluid and serum for tuberculous pleural effusions.Methods The concentrations of PCT and ADA both in serum and pleural fluid in one hundred and twenty-eight patients with pleural effusion were detected.These patients were divided into three groups.Fifty-two patients with tuberculous plueral effusion were composed of the tuberculous group.Twenty-two patients with parapneumonic effusion composed the pneumonic group and forty patients with malignant pleural effusion and fourteen patients with heart faliure composed of the control group.Results There were no statistically significant differences in serum PCT among the three groups（P 〉0.05）.PCT of pleural fluid was significantly increased in tuberculous and parapneumonic groups compared to the control group（P 〈0.05）.ADA activities in tuberculous serum and pleural fluid were both higher than those in the parapneumonic and the control groups（P 〈0.01）.The ratio of ADA in pleural fluid and serum（P /S） was calculated.The diagnostic sensitivity and specificity of P /S（cut-off value 1.27） were 92.3% and 100% respectively for tuberculous pleural effusions calcuted by receiver operating curve.Conclusion Combined measurements of PCT and ADA in pleural fluid are useful in diagnosing tuberculous pleural effusions.