[Gamma-interferon and adenosine deaminase in the diagnosis of tuberculous pleurisy].

O T Titarenko, D S Esmedliaeva, M E D'iakova, T L Perova, M Iu Popov
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Abstract

The paper compares the characteristics of the informative value of tests determining the activity of adenosine deaminase (ADA) activity and the level of gamma-interferon (gamma-IFN) for the differential diagnosis of tuberculous pleurisy (n = 35) and non-tuberculous pleural effusion (n = 53). Both tests were ascertained to have the similar differentially diagnostic capacities with their threshold values of 35 U/l and 180 pg/ ml, respectively. At the same time, the sensitivity and specificity of the ADA test were 98.4% and these of the gamma-IFN test were 94.3 and 96.2%, respectively, with the positive and negative predictive value being 91.3 and 98.3% and 94.3 and 96.2%, respectively, and with the diagnostic value of 94.5% for the ADA test and 96.4% for the gamma-IFN test. There was a high unidirectionality of changes in both values: it was higher than the cut-off points in 94.1% of the patients with tuberculous pleurisy and below them in 88.7% of those with other pleural effusions.

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γ -干扰素和腺苷脱氨酶在结核性胸膜炎诊断中的价值
本文比较了测定腺苷脱氨酶(ADA)活性和γ -干扰素(γ - ifn)水平在结核性胸膜炎(n = 35)和非结核性胸腔积液(n = 53)鉴别诊断中的信息价值的特点。两种检测方法均具有相似的鉴别诊断能力,其阈值分别为35 U/l和180 pg/ ml。同时,ADA检测的敏感性和特异性分别为98.4%和94.3%,γ - ifn检测的敏感性和特异性分别为96.2%,阳性预测值和阴性预测值分别为91.3%和98.3%和94.3%和96.2%,ADA检测的诊断价值为94.5%,γ - ifn检测的诊断价值为96.4%。这两个值的变化具有高度的单向性:94.1%的结核性胸膜炎患者高于临界值,88.7%的其他胸腔积液患者低于临界值。
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