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目的 :总结结核性腹水的临床特点 ,寻找诊断结核性腹水的高敏感、高特异的检查方法。方法 :检测 2 1例结核性腹水患者的腹水腺苷脱氨酶 (ADA)及血清CA12 5水平 ,并与 2 8例肝硬化腹水及 2 2例恶性腹水作对照。结果 :结核性腹水组腹水ADA水平为 (70 .31± 2 5 .79)U/L(均值±标准差 ) ,与肝硬化组 (10 .0 0± 5 .2 6 )U/L及恶性腹水组 (14 .6 3± 12 .0 4 )U/L相比 ,显著高于对照组 (P <0 .0 1)。以ADA≥ 4 0U/L为诊断界值 ,其诊断结核性腹水的敏感性为 87.5 % ,特异性为 98.0 % ,阳性预测值为 93.3% ,阴性预测值为 96 .1% ,准确性为 95 .5 %。三组血清CA12 5水平多有升高。结论 :ADA升高对诊断结核性腹水有重要价值 ,CA12 5升高对诊断结核性腹水有一定的参考价值
OBJECTIVE: To summarize the clinical features of tuberculous ascites and to find a highly sensitive and highly specific test for the diagnosis of tuberculous ascites. Methods: Ascites adenosine deaminase (ADA) and serum CA12 5 levels were measured in 21 patients with tuberculous ascites and compared with 28 ascites in cirrhosis and 22 malignant ascites. Results: The level of ADA in ascites of tuberculous ascites group was (70.31 ± 2.57) U / L (mean ± standard deviation), which was significantly higher than that in cirrhosis group (10.00 ± 5.26) U / L and malignant Ascites group (14.6 ± 12.0.4) U / L was significantly higher than that in the control group (P <0.01). The diagnosis of tuberculous ascites was 87.5%, specificity was 98.0%, positive predictive value was 93.3%, negative predictive value was 96.1% with accuracy of 95 .5%. Three groups of serum CA12 5 levels increased. Conclusion: Elevated ADA is of great value in the diagnosis of tuberculous ascites. Elevated CA125 may be helpful to diagnosis of tuberculous ascites.