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目的探讨血清腺苷脱氨酶(ADA)水平,对于马尔尼菲青霉菌病(PSM)的诊断价值。方法将2010年1月至2013年12月,长沙市第一医院48例合并马尔尼菲青霉菌(PM)感染的艾滋病(AIDS)病人作为PSM组,其中10例同时合并结核病;同期按照性别年龄平衡原则,将未合并PM感染的AIDS病人50例作为非PSM组,其中10例合并结核病。采用酶偶联分光光度法检测两组血清ADA水平,并按照ADA水平绘制受试者工作曲线(ROC曲线)。结果合并PSM组病人的平均血清ADA水平中位数为38.30mg/L,对照组为14.70mg/L,差异有统计学意义(P<0.05)。绘制ROC曲线显示,ADA对PSM的诊断切点值为23.50 mg/L,敏感度为76.6%,特异度为91.7%。结论合并PSM感染的AIDS病人血清ADA水平明显增高,以23.50mg/L为诊断界值,有较高的敏感度和特异度。ADA检测可作为AIDS病人合并PSM的辅助诊断方法之一。
Objective To investigate the diagnostic value of serum adenosine deaminase (ADA) level for Penicillium marneffei (PSM). Methods From January 2010 to December 2013, 48 AIDS patients with Penicillium marneffei (PM) infection in the First Hospital of Changsha City were selected as PSM group. Ten of them were complicated with tuberculosis at the same time. According to sex age Balance principle, 50 cases of AIDS patients without PM infection as non-PSM group, of which 10 cases of tuberculosis. Enzyme-coupled spectrophotometry was used to detect serum ADA levels in both groups, and the working curve (ROC curve) of the subjects was drawn according to ADA level. Results The median serum ADA level was 38.30mg / L in the PSM group and 14.70mg / L in the control group, with significant difference (P <0.05). The ROC curves were drawn. The diagnostic cutoff value of ADA for PSM was 23.50 mg / L, the sensitivity was 76.6% and the specificity was 91.7%. Conclusion Serum ADA levels in PSM-infected AIDS patients were significantly higher, with a sensitivity of 23.50mg / L and a higher sensitivity and specificity. ADA test can be used as one of the auxiliary diagnosis methods of AIDS patients combined with PSM.