关键词: 降钙素原；腺苷脱氨酶；结核性胸腔积液；恶性胸腔积液；鉴别诊断；实验诊断

Abstract:

Objective   To determine the diagnostic value of combined detection of procalcitonin (PCT) and adenosine deaminase (ADA) for tuberculous pleural effusion. Methods   A total of 90 patients were classified into three groups depending on the cause of their effusion： tuberculous group(n=48)， malignant group(n=28) and heart failure (control) group(n=14). The levels of PCT and ADA both in serum and pleural effusion were detected by enzyme-linked immunosorbant assay (ELISA). Results   The levels of PCT and ADA in pleural effusion were significantly higher in tuberculous group than in malignant group and control group， but there were no significant differences in serum. PCT and ADA levels both in pleural effusion and serum had no significant differences between malignant group and control group. Using the PCT level (>0.325ng/mL) and the ADA level (>45U/L) in pleural effusion as critical values， the diagnostic sensitivities for PCT and ADA in tuberculous pleural effusion were 79.2% and 87.5%， and specificity were 83.3% and 90.5%. Furthermore，when the two indexes were concatenated， the diagnostic sensitivity for tuberculous pleural effusion was 75.0%， and specificity was 97.6%.While when they were paralleled， the sensitivity was 93.8%， and specificity was 81.0%. Conclusion   Combined detection of PCT and ADA in pleural effusion can significantly increase the sensitivity and specificity for tuberculoous plueral effusion diagnosis， which has important clinical significance for preventing misdiagnosis and missed diagnosis. But determination of PCT and ADA in serum has no significant diagnostic value for tuberculous plueral effusion.

Key words: Procalcitonin； Adenosine deaminase； Tuberculous pleural effusion； Malignant pleural effusion； Differential diagnosis；  Laboratory diagnosis