改良胸水常规检测在结核性和癌性胸水鉴别诊断中的价值  

Diagnostic value of modified pleural effusion in the differential diagnosis of tuberculous and malignant pleural effusion

作　　者：吴双辽 李博成 

机构地区：[1]温州市中心医院检验科,浙江温州325000

出　　处：《中国卫生检验杂志》2016年第24期3564-3565,3568,共3页Chinese Journal of Health Laboratory Technology

摘　　要：目的探讨检测改良胸水常规检查中淋巴细胞/中性粒细胞(L/N)、淋巴细胞绝对值、蛋白定量鉴别结核性胸水和癌性胸水的临床意义。方法选取110例胸腔积液患者,其中结核性胸水65例、癌性胸水45例,胸水常规用迈瑞BC6900仪器体液模式和牛鲍池计数板进行有核细胞计数,分类采用瑞-姬染色后显微镜CX-21下计数100个细胞;ADA采用AU5400连续监测法检测;CEA采用电化学发光法检测;蛋白采用奥森多5600干化学法。结果 L/N、淋巴细胞绝对值、蛋白定量在结核性胸水中的含量高于癌性胸水,差异有统计学意义(P<0.05)。L/N、淋巴细胞百分比、淋巴细胞绝对值、蛋白定量、胸水ADA的ROC曲线下面积分别为0.566、0.769、0.923、0.772、0.955。结论改良胸水常规检测对于结核性胸水和癌性胸水具有良好的鉴别价值。Objective To investigate the clinical significance of improved hydrothorax routine L / N（ lymphocytes / neutrophils）,lymphocyte number absolute value and protein in differentiating tuberculous hydrothorax and carcinomatous hydrothorax. Methods 110 patients with pleural effusion were selected,including 65 cases with tuberculous pleural effusion,45 cases with malignant pleural effusion; karyocyte were counted by using MINDRAY BC-6900 instrument fluid model and bovine abalone pool;100 cells were counted in classification by Wright Giemsa staining under microscope after CX-21; to detect ADA by AU5400 continuous monitoring method,evaluate CEA by electrochemiluminescence,and to detect protein by OCD 5600 dry chemical method. Results L / N,the number of the lymphocytes in absolute value and protein content in tuberculous pleural effusion were higher than that of malignant pleural effusion,and the differences were statistically significant（ P 0. 05）. The area under the ROC curve of L / N,lymphocyte percentage,lymphocyte absolute value,protein quantification,pleural effusion ADA was0. 566,0. 769,0. 923,0. 772,0. 955 respectively. Conclusion The improved hydrothorax routine has good value in the diagnosis of tuberculous pleural effusion and malignant pleural effusion.

关 键 词：结核性胸水 癌性胸水 鉴别诊断 改良胸水常规 

分 类 号：R446.8[医药卫生—诊断学]