胸水腺苷脱氨酶结合ROSE技术在结核性胸膜炎诊断中的应用

目的:探讨胸水腺苷脱氨酶(ADA)联合快速现场评价(ROSE)技术在结核性胸膜炎诊断中的应用.方法:选取100例疑似结核性胸膜炎患者作为研究对象,依据诊断结果的不同将其分为结核性胸膜炎组(39例)和非结核性胸膜炎患者组(61例).纳入研究者均采用全自动生化分析仪行胸水ADA(PADA)和血清ADA(SADA)水平检测,...

Application of ADA of pleural fluid combined with ROSE technique in the diagnosis of tuberculous pleurisy

Objective:To explore the application of adenosine deaminase(ADA)of pleural fluid combined with rapid on site evaluation(ROSE)technique in the diagnosis of tuberculous pleurisy.Methods:100 patients with suspected tuberculous pleurisy were selected as the study objects,and they were divided into tuberculous pleurisy group(39 cases)and non-tuberculous pleurisy group(61 cases)according to differently diagnostic results.The levels of pleural effusion ADA(PADA)and serum ADA(SADA)of the patients were detected by full automatic biochemical analyzer,and ROSE technique was used to detect and confirm tuberculous pleurisy,and receiver operating characteristic(ROC)curve was used to evaluate the diagnostic values of ADA combined with ROSE technique and single ROSE technique in tuberculous pleurisy.Results:Compared with non-tuberculous pleurisy group,PADA and PADA/SADA of pleural fluid of tuberculous pleurisy group significantly decreased(t=127.108,t=25.570,P<0.05),and the level of SADA significantly increased(t=5.287,P<0.05),and the difference of the positive and negative proportions of tuberculous pleurisy group that was detected by ROSE technique was significant(x²=28.125,P<0.05).In the diagnosis of ROSE for tuberculous pleurisy,30 cases were true positive,and 9 cases were false negative,and 14 cases were false positive and 47 cases were true negative.The sensitivity,specificity and accuracy of that were 76.92%,77.05%and 77.00%,respectively.In the diagnosis of ADA of pleural fluid with ROSE for tuberculous pleurisy,36 cases were true positive,and 3 cases were false negative,and 3 cases were false positive,and 58 cases were true negative.The sensitivity,specificity and accuracy were 92.31%,95.08%and 94.00%.Compared with the single ROSE diagnosis for tuberculous pleurisy,the specificity and accuracy of ADA of pleural fluid combined with ROSE in diagnosing tuberculous pleurisy were significantly increased(x²=8.270,x²=11.656,P<0.05),and the area under the curve(AUC)of combined diagnosis was significantly increased(Z=4.355,P<0.05).Conclusion:Both ROSE technique and ADA of pleural fluid combined with ROSE technique have a certain of diagnostic values for tuberculous pleurisy,however,ADA of pleural fluid combined with ROSE technique has more valuable in the diagnosis for tuberculous pleurisy,which can provide a reference for the diagnosis of tuberculous pleurisy.