抽象的
结核性胸膜患者胸膜肺液中腺苷脱氨素酶(ADA)活性的升高,虽然用于诊断,是未知的起源。在这项工作中,我们在350名患者中确定了ADA活动和2'-脱氧腺苷脱氨酶和ADA-2的活动。我们还考虑了结果对结核性胸膜炎的高胸膜液体ADA的起源并估计了2'-脱氧腺苷脱氨酶,ADA-2和总ADA活性的诊断效率,并且不包含2'-脱氧腺苷脱氨基酶/ ADA活动比例在组合标准中。通过先前建立的标准(60名男性/ 18名女性)或结核(49名男性/ 27名女性),肿瘤(50名男性/ 39名女性),ParaPneux(36名男性/ 19名女性),脓肿(36名男性/ 19名女性),脓肿(11名男性/ 3名女性),或杂项(25名男性/ 13名女性)渗出。分别为127.5 +/- 2.9,103 +/-20.5和42.8 +/14 U.L-1分别为127.5 +/- 2.9,103 +/- 29.5和42.8 +/-14 U.L-1分别的总ADA,ADA-2和2'-脱氧糖苷酶活性。分别具有47,40和22 u.L-1的诊断阈值,结核病的ADA,ADA-2和2'-脱氧腺苷脱氧糖酶的敏感性为100,100和95%;他们的特异性91,96和92%;他们的效率分别为93,97和93%。一百个潮流(全部76个结核,12个肿瘤,4例,4例,脓肿渗漏物)具有ADA水平> 47 U.L-1;其中,8个肿瘤,1例,所有结核渗透剂具有2'-脱氧腺苷脱氧酶/ ADA活性比<0.49。 The criterion of simultaneously having ADA > 47 U.L-1, ADA-2 > 40 U.L-1 and a 2'-deoxyadenosine deaminase/ADA activity ratio < 0.49 was satisfied by all the tuberculous effusions but only eight others (all neoplastic) (sensitivity 100%, specificity 97%, efficiency 98%). We conclude that: 1) high total ADA activity in tuberculous pleural effusions is due mainly to an increase in ADA-2, and, therefore, originated from the only known source monocytes and macrophages; 2) ADA-2 was a more efficient diagnostic marker of tuberculous pleurisy than total ADA activity, although the difference was not statistically significant; and 3) among effusions with high total ADA the 2'-deoxyadenosine deaminase/ADA activity ratio differentiates tuberculous effusions from empyemas and parapneumonic effusions, but fails to discriminate well between tuberculous and neoplastic effusions.