【摘要】 目的 應(yīng)用受試者工作特征曲線（receiver operating characteristic curve，ROC曲線）探討α-L-巖藻糖苷酶（AFU）對(duì)惡性腹水和非結(jié)核良性腹水的診斷價(jià)值。 方法 2004年7月—2008年1月對(duì)213例診斷明確的良、惡性腹水（其中良性腹水117例、惡性腹水96例）AFU活性進(jìn)行檢測(cè)。采用ROC曲線評(píng)價(jià)AFU的診斷靈敏度、特異度、準(zhǔn)確性、陽(yáng)性預(yù)測(cè)值、陰性預(yù)測(cè)值、陽(yáng)性似然比、陰性似然比及Youden指數(shù)，評(píng)價(jià)其診斷效率?！〗Y(jié)果 惡性腹水組AFU水平（164.96±87.72） μmol/（L?h），良性腹水組（104.02±62.07） μmol/（L?h），兩者比較差異有統(tǒng)計(jì)學(xué)意義（Plt;0.01）。AFU診斷惡性腹水的ROC 曲線下面積為0.754±0.034，最佳分界值101.95 μmol/（L?h）。以AFU≥101.95 μmol/（L?h）來(lái)預(yù)測(cè)惡性腹水，其診斷的靈敏度為82.3%，特異度為63.2%，準(zhǔn)確性為72.8%、陽(yáng)性預(yù)測(cè)值為65.3%、陰性預(yù)測(cè)值為83.1%、陽(yáng)性似然比為2.23、陰性似然比為0.28及Youden指數(shù)為0.455?！〗Y(jié)論 腹水AFU活性檢測(cè)有助于惡性腹水和非結(jié)核良性腹水的鑒別診斷，是一個(gè)比較理想的實(shí)用指標(biāo)，適合于基層醫(yī)院的臨床應(yīng)用?！続bstract】 Objective To assess the value of α-L-fucosidase (AFU) levels with receiver operating characteristic curve (ROC curve) in the diagnosis of malignant and non-tuberculous benign ascites. Methods Ascitic AFU activity was measured in 213 patients (117 with benign ascites and 96 with malignant ascites) diagnosed with benign or malignant ascites. The diagnostic sensitivity (SEN), specificity (SPE), accuracy, positive predictive value (PV+), negative predictive value (PV-), positive likelihood ratio (LR+), negative likelihood ratio (LR-) and Youden index (YI) of AFU were assessed with receiver operating characteristic curve, and the diagnostic effectiveness of AFU was evaluated. Results The average level of AFU in the malignant group [(164.96±87.72) μmol/(L?h)] was significantly higher than that in the benign group [(104.02±62.07) μmol/(L?h)] (Plt;0.01). The area under the curve (AUC) of the ROC curve of AFU was 0.754±0.034 for malignant ascites diagnosis, and the optimal cut-off value was 101.95 μmol/(L?h). When an AFU level equal to or higher than 101.95 μmol/(L?h) was used to predict malignant ascites, the diagnostic sensitivity was 82.3%, specificity was 63.2%, accuracy was 72.8%, PV+ was 65.3%, PV- was 83.1%, LR+ was 2.23, LR- was 0.28 and YI was 0.455. Conclusion Detection of AFU activity in ascites is helpful to differentiate the diagnose between malignant and non-tuberculous benign ascites, which is a relatively ideal index to fit for clinical application of local hospitals.