【摘要】 目的 探讨腺苷脱氨酶(ADA)诊断结核性胸膜炎的影响因素。方法 收集广州市胸科医院2011年10月至2014年9月收治的162例明确诊断为结核性胸膜炎患者。检测患者胸腔积液的ADA值,并以胸腔积液ADA值43 TU/L为临界值,分成低ADA组(<43 IU/L,32例)和高ADA组(≥43 IU/L,130例)。评估两组患者年龄、性别、体质量指数、吸烟、既往患结核病及合并疾病与胸腔积液ADA活性的相关性。采用SPSS 20.0软件进行统计学分析,计量资料采取t检验,计数资料采用X~2检验,采用多因素非条件logistic回归方程分析相关性,P<O.05为差异有统计学意义。结果(1)两组结核性胸膜炎中,低ADA组年龄均值为(60.3±14.4)岁,明显高于高ADA组[(41.8±20.1)岁],差异有统计学意义(t=2.105,P<0.05);低ADA组体质量指数值为(17.7±1.3)kg/m~2,明显低于高ADA组[(21.2±3.2)kg/m~2],差异有统计学意义(t=2.341,P<0.05)。(2)在低ADA组中,通过多因素回归分析,体质量指数、目前吸烟和年龄是影响结核性胸膜炎患者胸腔积液ADA值的独立因素,三者对其的影响强度依次下降[OR值(95%CI值)分别为3.345(2.101~5.737)、2.822(2.095~8.609)和1.338(1.080~1.825);P值分别为0.022、0.031和0.003]。结论 年龄、体质量指数和吸烟能够影响结核性胸膜炎患者胸腔积液中的ADA水平。临床医生采用ADA诊断结核性胸膜炎时需要充分考虑这些因素。更多还原

【Abstract】 Objective To explore the influencing factors of adenosine deaminase(ADA) on the diagnosis of tuberculous pleurisy.Methods The ADA level in pleural fluid and clinical records of 162 patients with tuberculous pleurisy admitted from October 2011 to September 2014 in Guangzhou Chest Hospital were evaluated retrospectively.The patients were divided into two groups:low-ADA(<43 IU/L,32 patients) group and high-ADA(≥43 IU/L,130 patients) group.The correlation between age,sex,body mass index(BMI),smoking status,history of tuberculosis and combined diseases and the activity of ADA in pleural effusion were evaluated in each group.Statistical analysis was conducted by SPSS 20.0,P<0.05 was considered statistically significant Results(l)The average age in low-ADA group((60.3±14.4) years) was significantly higher than that in high-ADA group((41.8±20.1) years),the difference was statistically significant(t = 2.105,P<0.05).BMI in low-ADA group((17.7±1.3) kg/m~2) was lower than that in high-ADA group((21.2 + 3.2) kg/m~2),there was statistically significant difference(t=2.341,P<0.05).(2)BMI,current smoker and age were predictive of TB pleurisy with low ADA and declined power in turn in low-ADA group in multivariate logistic regression(QR = 3.345,95%CI = Z.101 —5.737;OR=2.822,95%CI=2.095-8.609 and OR=1.338,95%CI=1.080-1.825 respectively,all P<0.05).Conclusion Age,BMI and current smoker can affect the ADA level of tuberculous pleural effusion.Physicians snould consider these influence factors on the diagnosis of TB pleurisy when using plural ADA.更多还原