Tüberküloz plörezilerin ayırıcı tanısında plevral sıvı ve serum adenozin deaminaz ve lizozim düzeylerinin yararı

Çalışmamızda tüberküloz (Tbc) plörezilerin diğer hastalıklara bağlı plörezilerden ayrılmasında pevral sıvı ve serum adenozin deaminaz (ADA) ve lizozim düzeylerinin yaran araştırıldı. Bu amaçla 26 tüberküloz ve 26 non-tüberküloz (16 malign, 8 transüdatif, 2 ampiyem) plörezi vakasının plevral sıvı ve serumları ile 20 sağlıklı kişinin serumlarındaki ADA ve lizozim değerleri saptandı. ADA düzeyleri Giusti kolorimetrik yöntemi, lizozim ise Litwack modifıye türbidimetrik yöntemi ile belirlendi. Plevral sıvı ADA düzeyleri ortalaması tüberkülozda 96.8U45.68 U/L, non-tüberküloz grupta 23.15±15.17 U/L idi. Plevral sıvı lizozim değerleri tüberkülozda 16.88±10.12 $\mu$g/ml, non-tüberküloz grupta ise 10.47±1.68 $\mu$g/ml idi. Her iki parametre de tüberkülozlularda non-tüberküloz gruba göre anlamlı derecede yüksekti (sırasıyla p

The usefulness of pleural fluid and serum adenosine deaminase and lysosyme levels in differential diagnosis of tuberculous pleurisies

In our study, we have investigated the usefulness of pleural fluid and serum ADA and lysozyme levels in differentiating tuberculous pleurisy from pleurisies caused by other diseases. We have determined the ADA and lysozyme values in pleural fluids and sera from 26 tuberculous and 26 non-tuberculous (16 malignant, 8 transudative, 2 empyemateus) pleurisy cases and in sera from 20 healthy individuals. The mean pleural fluid ADA value in tuberculosis was 96.81±45.68 U/L, and in non-tuberculolous group was 23.15±15.17 U/L. The mean pleural fluid lysozyme values was determined in tuberculous group as 16.88±10.12 $\mu$g/ml, in non-tuberculous group as 10.47$\pm$1.68$\mu$g/ml. As a result of this, both pleural fluid ADA and lysozyme levels were significantly higher in tuberculous group than the other groups (p<O.OOOl). The mean value of serum ADA levels of the tuberculous patients (28.68±11.84 U/L) was significantly higher than the non-tuberculous patients (20.32±8.09 U/L): p<O.Ol. Serum lysosyme levels did not show any significant difference between tuberculous and non-tuberculous groups. The mean pleural fluid/serum ADA ratio in tuberculous group (3.96±2.73) was significantly higher (p<O.OOOl) than that of non-tuberculous patients (1.21$\pm$1.67). Pleural fluid/serum lysozyme ratio in tuberculous group was 1.82$\pm$1.70, much higher than non-tuberculous group (1.03±0.17) and showed significant difference (p<0.05). In conclusion, our study showed that determination of ADA and lysozyme may be used as a supporting tools in differential diagnosis of tuberculous pleural effusions.

Kaynakça

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