结核性及癌性胸膜炎多项指标检测与病理改变关系探讨  

Correlated multiple paraineters in pleural effusionwith pathology of pleurae for differential diagnosis oftuberculous and carcino'uatous pleuritis

作　　者：余绍珍[1] 戴芸[1] 赵淑霞 汝磊生[1] 

机构地区：[1]石家在解放军白求恩国际和平医院

出　　处：《中华结核和呼吸杂志》1995年第2期88-90,共3页Chinese Journal of Tuberculosis and Respiratory Diseases

摘　　要：对经胸膜活组织检查（活检）病理确诊的５４例结核性胸膜炎和２０例胸膜肿瘤行病理组织分型与多项指标检查结果分析。５４例结核性胸膜炎（结胸）病理分型为增殖型、渗出型、干酪样坏死型和慢性型。２０例胸膜肿瘤转移性１７例，原发性胸膜间皮瘤３例。若将胸液腺苷脱氨酶（ＡＤＡ）、溶菌酶（ＬＺＭ）活性切线分别定为３５Ｕ／Ｌ和３０ｍｇ／Ｌ，胸液／血清（Ｐ／Ｓ）比值，ＡＤＡ、ＬＺＭ分别定为＞１．４和＞１．１时，则诊断结核之敏感性和特异性皆可达１００％。胸液中癌细胞发现率仅为４５％。结素试验阴性不能除外结核。本结果提示组织病理类型及血性胸液可影响多项指标检测结果。he level of ADA, LZM, leukocyte count , lym-phocyte in tuberculous effusion is higher than that ofcarcinomatous effusion(<0.05). All resuits showedthat the change of multiple parameters is related to thepathological manifestation of pleurae. The false posrtiveor negative result was influenced by pathological appearance and bloody character of pleural effusion. Using theADA , LZM cut off value at35U and 30mg, respective-ly , and pleurallserum ADA ratio <1. 4 , LZM> 1. 1 , asensitivity and specificity of 100 percent were achieved.

关 键 词：结核 胸膜肿瘤 腺苷脱氨酶 胸膜炎 癌 病理 

分 类 号：R521.702[医药卫生—内科学] R734.302[医药卫生—临床医学]