| 赵冠华,郜赵伟,董 珂,黄 晶,张惠中.血清腺苷脱氨酶检测在几种自身免疫性疾病中的临床意义研究[J].,2017,17(4):672-675 |
| 血清腺苷脱氨酶检测在几种自身免疫性疾病中的临床意义研究 |
| Study on the Clinical Significance of Serum Adenosine Deaminase in Several Autoimmune Diseases |
| 投稿时间：2016-09-01 修订日期：2016-09-25 |
| DOI：10.13241/j.cnki.pmb.2017.04.018 |
| 中文关键词: 自身免疫性疾病 腺苷脱氨酶 系统性红斑狼疮 类风湿性关节炎 重症肌无力 |
| 英文关键词: Autoimmune disease Adenosine deaminase Systemic lupus erythematosus Rheumatoid arthritis Myasthenia grais |
| 基金项目:国家自然科学基金项目（81572974） |
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| 中文摘要: |
| 摘要 目的：探讨血清腺苷脱氨酶(ADA)检测在几种自身免疫性疾病诊断中的应用价值。方法：收集确诊的系统性红斑狼疮(127例)、类风湿性关节炎(103例)和重症肌无力患者(34例)的血清标本，以同时期体检的正常成人(149例)为对照，采用ADA偶联嘌呤核苷磷酸化酶(PNP)和黄嘌呤氧化酶(XOD)法检测血清中ADA活性。结果：系统性红斑狼疮、类风湿性关节炎、重症肌无力患者和正常体检者血清中的ADA活性均值分别为(12.91±5.82)U/L、(10.91±3.70)U/L、(9.21±3.57)U/L、(8.73±2.79)U/L。系统性红斑狼疮、类风湿性关节炎患者血清中ADA活性均显著高于正常体检者(P<0.05)，而重症肌无力患者血清中ADA活性和正常体检者相比差别无统计学意义(P>0.05)。ROC结果显示将血清ADA活性>10U/L同时作为RA和SLE诊断的阳性值，ADA活性诊断SLE的AUC为0.748，敏感性为59.8%，特异性为83.2%。ADA活性诊断RA的敏感性为42.7%，特异性为83.2%。血清ADA活性为10 U/L作为诊断的参考值上限，其诊断SLE的效果优于ESR和hs-CRP，其诊断RA的效果低于ESR和hs-CRP。结论：系统性红斑狼疮、类风湿性关节炎患者血清ADA活性均有升高，在系统性红斑狼疮患者中升高更为明显，可作为系统性红斑狼疮潜在的辅助诊断标志物。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the diagnostic value of serum adenosine deaminase in several autoimmune diseases. Methods: Serum samples of patients with system lupus erythematosus (SLE, n=127), rheumatoid arthritis (RA, n=103) and myasthenia gravis (MG, n=34) were collected, the serum of normal adults as control. The serum ADA activity was detected by using ADA coupling purine nucleoside phosphorylase (PNP) and xanthine oxidase (XOD) method. Results: The average level of serum ADA activity in the SLＥ patients, RA patients, MG patients and normal subjects were (12.91±5.82) U/L, (10.91±3.70)U/L, (9.21±3.57)U/L, (8.73±2.79)U/L respectively. The ADA activity in serum of SLE, RA were significantly higher than that in controls(P<0.05), while the serum ADA activity of MG patients showed significant difference compared with controls(P>0.05). The receiver operating characteristic curve (ROC) showed that AUC was 0.748 when taking ADA activity >10U/L as the cutoff value, the sensitivity of ADA activity assay in the diagnosis of SLE was 59.8% and the specificity was 83.2%. The sensitivity of ADA activity in the diagnosis of RA was 42.7%, the specificity was 83.2%. The diagnosis effect of serum ADA activity in SLE was better than ESR and hs-CRP while lower than ESR and hs-CRP in RA. Conclusion: The average level of serum ADA activity in the SLE patients and RA patients were higher than in controls, and increased more obviously in SLE. The ADA activity could be a potential diagnostic serum marker in SLE. |
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