Índice LDH/ ADA de líquido pleural comparado con ADA en tuberculosis pleural
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Date
2024-08-12
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Universidad Nacional de Trujillo
Abstract
La tuberculosis pleural es una de las causas más comunes de derrame pleural en regiones endémicas, lo que resalta la importancia de métodos diagnósticos eficientes y precisos. Al comparar sistemáticamente el índice LDH/ADA con la medición de ADA sola, esta investigación puede proporcionar evidencia sólida sobre la eficacia de este nuevo enfoque diagnóstico.
Este trabajo tiene como objetivo determinar si el índice lactato deshidrogenasa/adenosina desaminasa de líquido pleural tiene mayor utilidad que la adenosina desaminasa en pacientes con DP por tuberculosis en el Hospital Víctor Lazarte Echegaray de Trujillo durante el período 2020-2022.
La investigación se llevará a cabo en pacientes con DP tipo exudado atendidos en el Servicio de Neumología del Hospital Víctor Lazarte Echegaray durante el período 2020-2022. Se incluirán en el estudio aquellos pacientes que cumplan con los criterios de inclusión específicos. Se realizarán procedimientos de toracentesis, biopsia pleural y estudios de laboratorio para determinar la presencia de tuberculosis pleural, y se registrarán los valores de ADA y del índice LDH/ADA en el líquido pleural.
Se determinará de la sensibilidad, especificidad, valor predictivo positivo (VPP), valor predictivo negativo (VPN), y razón de verosimilitud positiva y negativa tanto para el ADA como para el índice LDH/ADA de líquido pleural. Ademas se establecerá el punto de corte óptimo del índice LDH/ADA de líquido pleural utilizando la curva ROC (Receiver Operating Characteristic) y la fórmula de Youden, con el objetivo de identificar el umbral que maximice la precisión diagnóstica.
Abstract Pleural tuberculosis is one of the most common causes of pleural effusion in endemic regions, highlighting the importance of efficient and accurate diagnostic methods. By systematically comparing the LDH/ADA ratio with ADA measurement alone, this research may provide strong evidence on the efficacy of this new diagnostic approach. This work aims to determine whether the pleural fluid lactate dehydrogenase/adenosine deaminase ratio is more useful than adenosine deaminase in patients with TB PD at the Víctor Lazarte Echegaray Hospital in Trujillo during the period 2020-2022. The research will be carried out in patients with exudate-type PD treated at the Pulmonology Service of the Víctor Lazarte Echegaray Hospital during the period 2020-2022. Those patients who meet the specific inclusion criteria will be included in the study. Thoracentesis, pleural biopsy, and laboratory studies will be performed to determine the presence of pleural tuberculosis, and the values of ADA and the LDH/ADA ratio in the pleural fluid will be recorded. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and positive and negative likelihood ratio will be determined for both the ADA and the LDH/ADA ratio in pleural fluid. In addition, the optimal cut-off point for the LDH/ADA ratio in pleural fluid will be established using the Receiver Operating Characteristic (ROC) curve and the Youden formula, with the aim of identifying the threshold that maximizes diagnostic accuracy.
Abstract Pleural tuberculosis is one of the most common causes of pleural effusion in endemic regions, highlighting the importance of efficient and accurate diagnostic methods. By systematically comparing the LDH/ADA ratio with ADA measurement alone, this research may provide strong evidence on the efficacy of this new diagnostic approach. This work aims to determine whether the pleural fluid lactate dehydrogenase/adenosine deaminase ratio is more useful than adenosine deaminase in patients with TB PD at the Víctor Lazarte Echegaray Hospital in Trujillo during the period 2020-2022. The research will be carried out in patients with exudate-type PD treated at the Pulmonology Service of the Víctor Lazarte Echegaray Hospital during the period 2020-2022. Those patients who meet the specific inclusion criteria will be included in the study. Thoracentesis, pleural biopsy, and laboratory studies will be performed to determine the presence of pleural tuberculosis, and the values of ADA and the LDH/ADA ratio in the pleural fluid will be recorded. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and positive and negative likelihood ratio will be determined for both the ADA and the LDH/ADA ratio in pleural fluid. In addition, the optimal cut-off point for the LDH/ADA ratio in pleural fluid will be established using the Receiver Operating Characteristic (ROC) curve and the Youden formula, with the aim of identifying the threshold that maximizes diagnostic accuracy.
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Keywords
Tuberculosis Pleural, LDH Pleural, Adenosina Desaminasa Pleural