80例结核性及39例恶性胸腔积液的临床分析  

Clinical analysis of 80 cases of tuberculous pleural effusion and 39 cases malignant pleural effusion

作　　者：骆文志[1] 刘升明[1] 吴义[1] 

机构地区：[1]暨南大学附属第一医院呼吸科,广东广州510630

出　　处：《暨南大学学报（自然科学与医学版）》2012年第2期190-193,共4页Journal of Jinan University(Natural Science & Medicine Edition)

摘　　要：目的:回顾性分析结核性和恶性胸腔积液的临床表现和实验室检查结果,探讨其对结核性和恶性胸腔积液鉴别诊断的价值。方法:收集80例结核性胸腔积液患者和39例恶性胸腔积液患者的病例资料,重点对癌胚抗原(CEA)、乳酸脱氢酶(LDH)、腺苷脱氨酶(ADA)测定结果进行统计学分析,为进一步提高对结核性和恶性胸腔积液的认识和更好地鉴别诊断提供依据。结果:①两组胸腔积液乳酸脱氢酶(PLDH)水平及胸腔积液乳酸脱氢酶/血清乳酸脱氢酶(PLDH/SLDH)比值差异均无显著性(P>0.05);②两组胸腔积液腺苷脱氨酶(PADA)含量、血清腺苷脱氨酶(SADA)含量和胸腔积液腺苷脱氨酶/血清腺苷脱氨酶(PADA/SADA)比值差异比较均有统计学意义(P<0.05);③经多变量logistic回归分析,入选模型的因素为患病年龄、发热、胸腔积液颜色、PADA/SADA比值。结论:①PADA、SADA含量可作为结核性和恶性胸腔积液鉴别诊断的重要依据。结核组PADA约为40 U/L,低于目前普遍采用PADA>45 U/L的诊断标准;而PADA/SADA比值为(3.44±1.38),PADA/SADA比值越大则越有利于结核性胸腔积液的诊断;②logistic回归分析显示患病年龄、发热、胸腔积液颜色、PADA/SADA比值联合用于结核性和恶性胸腔积液的判别时有良好的准确性。Aim： Retrospective analysis on clinical manifestation and laboratory test results of tuberculous pleural effusion（TBPE）and malignant pleural effusion（MPE）,to probe into the value about the different diagnosis of TBPE and MPE.Methods： Eighty hospitalized patients with TBPE or MPE were analyzed retrospectively,particularly the content of CEA,LDH and ADA,which is for getting a better understanding of TBPE and MPE and improving the ability of differential diagnosis.Results： ①The PLDH levels and the PLDH/SLDH ratio were no significant difference in two groups（P0.05）.② The differences of the PADA levels,the SADA levels and the PADA/SADA ratios were statistically significant（P0.05）.③ After making use of multivariable logistic regression analysis,The valuable factors are onset age,fever,color of pleural effussion and the PADA/SADA ratio.Conclusion：① The content of PADA and SADA were important basis for different diagnosing TBPE and MPE.The PADA is about 40 U/L,which is lower than 45 U/L,that as diagnostic standard is generally adopted;Regarding PADA/SADA=1 as a liability standard,TBPE is greater than 1,MPE is fewer than 1,which is still need more discussion and the virtual PADA/SADA=（3.44±1.38）,but the ratio is bigger and more beneficial to TBPE.② The logistic regression analysis shows putting onset age,fever,color of pleural effussion,ratios of PADA/SADA together for different diagnosis of TBPE and MPE has superior correctness.

关 键 词：结核性胸腔积液 恶性胸腔积液 癌胚抗原 乳酸脱氢酶 腺苷脱氨酶 

分 类 号：R561.1[医药卫生—呼吸系统]