腺苷脫氨酶在結核性漿膜腔積液中診斷價值的循證評價_《中國循證醫學雜志》

作者：

李姣 ,  朱渝 , 屈藝 , 母得志

四川大學華西第二醫院兒科（成都 610041）;

關鍵詞：

結核性漿膜腔積液腺苷脫氨酶診斷價值系統評價

DOI：

10.7507/1672-2531.20100435

視頻：

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目的　探討腺苷脫氨酶（adenosine deaminase ADA）檢測在結核性漿膜腔積液中的診斷價值。
方法　檢索PubMed 和CNKI 數據庫，查閱關于ADA 在各種結核性漿膜腔積液診斷中應用的相關文獻并進行評價。
結果　國內外有多個RCT 和Meta 分析評價了對結核性漿膜腔積液中ADA 活性水平的診斷價值，現有證據表明ADA活性水平測定在各種肺外結核中的診斷敏感性和特異性都很高，各種肺外結核滲出液中ADA 活性水平的最佳閾值為40 IU/L 左右。
結論　檢測結核性漿膜腔積液患者滲出液中ADA 活性水平是一個快速、方便、安全有效的結核輔助診斷方法。

引用本文： 李姣,朱渝,屈藝,母得志. 腺苷脫氨酶在結核性漿膜腔積液中診斷價值的循證評價. 中國循證醫學雜志, 2010, 10(4): 495-498. doi: 10.7507/1672-2531.20100435 復制

1.	Inadomi JM, Kapur S, Kinkhabwala M, et al. The laparoscopicevaluation of ascites. Gastrointest Endosc Clin N Am, 2001, 11: 79-91.
2.	李欽云, 曹勵之. 結核性腦膜炎患兒腦脊液腺苷脫氨酶活力的變化. 北京醫學, 2008, 30(3): 432-435.
3.	Giusti G. Adenosine deaminase. In: Bergmeyer H, ed. Methods of Enzymatic Analysis. New York: Academic Press, 1974: 1092-1099.
4.	Slaats EH, Asberg EG, van Keimpema AR, et al. A continuous method for the estimation of adenosine deaminase catalytic concentration in pleural effusions with a Hitachi 705 discrete analyser. J Clin Chem Clin Biochem, 1985, 23: 677-682.
5.	Hillebrand DJ, Runyon BA, Yasmineh WG, et al. Ascitic fluid adenosine deaminase insensitivity in detecting tuberculous peritonitis in the United States. Hepatology, 1996, 24: 1408-1412.
6.	Liang QL, Shi HZ, et al. Diagnostic accuracy of adenosine deaminase in tuberculous pleurisy: A meta-analysis. Respiratory Medicine, 2008, 102, 744-754.
7.	Morisson P, Neves DD. Evaluation of adenosine deaminase in the diagnosis of pleural tuberculosis: a Brazilian meta-analysis. J Bras Pneumol, 2008, 34(4): 217-224.
8.	Trautner BW, Darouiche RO. Tuberculous pericarditis:optimal diag nosis and management. Clin Infect Dis, 2001, 33: 954-961.
9.	Cherian G. Diagnosis of tuberculous aetiology in pericardial effusions. Postgrad Med J, 2004, 80: 262-266.
10.	Tuon FF, Litvoc MN. Max Igor Banks Ferreira Lopes Adenosine deaminase and tuberculous pericarditis—A systematic review with meta-analysis. Acta Tropica, 2006, 99: 67-74.
11.	Riquelme A, Calvo M, Salech F, et al. Value of Adenosine Deaminase (ADA) in Ascitic Fluid for the Diagnosis of Tuberculous Peritonitis. J Clin Gastroenterol, 2006, 40: 705-710.
12.	Koh KK, In HH, Lee KH, et al. New scoring system using tumor markers in diagnosing patients with moderate pericardial effusions. Int J Cardiol, 1997, 61: 5-13.
13.	Burgess LJ, Maritz FJ, Le Roux I, et al. Use of adenosine deaminase as a diagnostic tool for tuberculous pleurisy. Thorax, 1995, 50: 672-674.

1. Inadomi JM, Kapur S, Kinkhabwala M, et al. The laparoscopicevaluation of ascites. Gastrointest Endosc Clin N Am, 2001, 11: 79-91.
2. 李欽云, 曹勵之. 結核性腦膜炎患兒腦脊液腺苷脫氨酶活力的變化. 北京醫學, 2008, 30(3): 432-435.
3. Giusti G. Adenosine deaminase. In: Bergmeyer H, ed. Methods of Enzymatic Analysis. New York: Academic Press, 1974: 1092-1099.
4. Slaats EH, Asberg EG, van Keimpema AR, et al. A continuous method for the estimation of adenosine deaminase catalytic concentration in pleural effusions with a Hitachi 705 discrete analyser. J Clin Chem Clin Biochem, 1985, 23: 677-682.
5. Hillebrand DJ, Runyon BA, Yasmineh WG, et al. Ascitic fluid adenosine deaminase insensitivity in detecting tuberculous peritonitis in the United States. Hepatology, 1996, 24: 1408-1412.
6. Liang QL, Shi HZ, et al. Diagnostic accuracy of adenosine deaminase in tuberculous pleurisy: A meta-analysis. Respiratory Medicine, 2008, 102, 744-754.
7. Morisson P, Neves DD. Evaluation of adenosine deaminase in the diagnosis of pleural tuberculosis: a Brazilian meta-analysis. J Bras Pneumol, 2008, 34(4): 217-224.
8. Trautner BW, Darouiche RO. Tuberculous pericarditis:optimal diag nosis and management. Clin Infect Dis, 2001, 33: 954-961.
9. Cherian G. Diagnosis of tuberculous aetiology in pericardial effusions. Postgrad Med J, 2004, 80: 262-266.
10. Tuon FF, Litvoc MN. Max Igor Banks Ferreira Lopes Adenosine deaminase and tuberculous pericarditis—A systematic review with meta-analysis. Acta Tropica, 2006, 99: 67-74.
11. Riquelme A, Calvo M, Salech F, et al. Value of Adenosine Deaminase (ADA) in Ascitic Fluid for the Diagnosis of Tuberculous Peritonitis. J Clin Gastroenterol, 2006, 40: 705-710.
12. Koh KK, In HH, Lee KH, et al. New scoring system using tumor markers in diagnosing patients with moderate pericardial effusions. Int J Cardiol, 1997, 61: 5-13.
13. Burgess LJ, Maritz FJ, Le Roux I, et al. Use of adenosine deaminase as a diagnostic tool for tuberculous pleurisy. Thorax, 1995, 50: 672-674.

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腺苷脫氨酶在結核性漿膜腔積液中診斷價值的循證評價

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腺苷脫氨酶在結核性漿膜腔積液中診斷價值的循證評價

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