결핵성 복수 환자에 있어서 복수 Adenosine Deaminase 활성도의 진단적 가치에 관한 연구

Objectives: In other to establish the etiology of ascites, routine analysis of fluid, bacteriologic studies, cytolgic tests and peritoneal biopsy are currently being employed. However, even with the above mentioned tests, the exact causes cannot be determined in more than 10% of cases. The purposes of our study are to determine the diagnostic significance of adenosine deaminase (ADA) activity in ascitic fluids which their etiologies have confirmed, and to determine the correlation between ADA activity and other biochemical data in tuberculous ascites. Methods: We have studied 21 cases of tuberculous ascites, 9 cases of malignant ascites, 32 cases of cirrhotic ascites, and 11 cases of miscellaneous etiologies. We have measured the ADA activity and values of routine examinations in ascites in each cases. Results: 1) The mean ascites ADA activity was 115.8±61.1 U/L in tuberculous ascites, 11.3±11.1U/L in cirrhotic ascites, 19.2±16.0 U/L in malignant ascites, and 13.7±12.6 U/L in miscellaneous ascites. 2) At a cutoff value of > 50 U/L, the sensitivity and the specificity for diagnosing tuberculous ascites were 95.2% and 98.4%, respectively. 3) In tuberculous ascites, the ascites ADA activity showed significant correlation with the ascites LDH activity (r=0.60), but other values of routine examination were not showed such correlation. Conclusion: It is suggested that the measurement of ascites ADA activity is simple and useful test in the diagnosis of tuberculous ascites. However, falsenegative results may occur in those in which ascites LDH activity is low.