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目的探讨腺苷脱氨酶(ADA)、半胱氨酸蛋白酶抑制剂C(CysC)在胸腔积液和血清中的比值对结核性胸腔积液的临床诊断价值。方法随机抽取2014年上半年邯郸市传染病医院收治的结核性胸膜炎患者50例(结核组),肺癌胸腔积液患者20例(恶性组),肝性胸腔积液患者30例(对照组),检测胸腔积液中CysC(PCysC)、ADA(PADA)和血清的CysC(SCysC)、ADA(SADA)浓度,分别计算两种指标在胸腔积液与血清中含量的比值。结果 (1)分别比较PADA、SADA,SCysC、PCysC,PCysC/SCysC和PADA/SADA 3组结果,差异均有统计学意义(P<0.05)。(2)依据ROC曲线确立PADA/SADA和PCysC/SCysC的临界值分别为1.58和2.30,PADA/SADA和PCysC/SCysC曲线下面积分别为0.880和0.786。结论 PADA/SADA和PCysC/SCys对结核性胸腔积液的诊断价值优于单纯使用PADA、SADA、PCysC和SCysC,可作为鉴别诊断结核性胸腔积液的指标应用于临床。
Objective To investigate the diagnostic value of adenosine deaminase (ADA) and cystatin C (CysC) in pleural effusion and serum in the diagnosis of tuberculous pleural effusion. Methods Fifty patients with tuberculous pleurisy (TB group), 20 patients with lung cancer with pleural effusion (malignant group) and 30 patients with hepatic hydrothorax (control group) were randomly selected from Handan Infectious Disease Hospital in the first half of 2014, The concentrations of CysC (PCysC), ADA (PADA) and serum CysC (SCysC) and ADA (SADA) in pleural effusion were measured to calculate the ratio of the two indexes in pleural effusion to serum content. Results (1) The results of PADA, SADA, SCysC, PCysC, PCysC / SCysC and PADA / SADA 3 groups were compared respectively, the differences were statistically significant (P <0.05). (2) According to the ROC curves, the critical values of PADA / SADA and PCysC / SCysC were 1.58 and 2.30 respectively, and the areas under PADA / SADA and PCysC / SCysC curves were 0.880 and 0.786, respectively. Conclusions PADA / SADA and PCysC / SCys are superior to PADA, SADA, PCysC and SCysC in the diagnosis of tuberculous pleural effusion. They can be used as an index in the differential diagnosis of tuberculous pleural effusion.