关键词: 结核, 胸膜；胸腔积液；腺苷脱氨酶；Meta分析

Abstract: Objective   To systematically review the diagnostic value of adenosine deaminase(ADA) of pleural effusion for tuberculous pleurisy. Methods   We searched Pubmed， Embase， Medline， Cochrane Library， CNKI，CBMdise and Wanfang Database， comprehensive collection studies about the diagnostic value of ADA for tuberculous pleurisy from Jan.2005 to Jun. 2016.Two reviewers screened literature according to the inclusion and exclusion criteria， extracted data， and assessed the quality of included studies. MetaDisc 1.4 was used to conduct the metaanalysis. Results   A total of 23 studies(3 312 cases) were finally included. The results of metaanalysis showed that the value of pooled sensitivity，specificity， LR+，LR-， diagnostic odds ratio(DOR) were SEN=0.876，95%CI=0.8590.892；SPE=0.899，95%CI=0.8850.912；LR+=8.139， 95%CI=6.64410.327；LR-=0.172，95%CI=0.1330.222；DOR=72.29， 95%CI=44.771116.75；AUC=0.9535.Conclusion   ADA determination is a sensitive and specific test for the diagnosis of tuberculous pleurisy. Pleural effusion ADA can be used as an auxiliary indicator in diagnosis of tuberculous pleural effusion.

Key words: tuberculosis, pleural, pleural effusion, adenosine deaminase;metaanalysis