酶学及免疫学指标对胸腔积液良恶性的鉴别诊断价值分析  

Analysis of the value of enzymatic and immunological indices in differential diagnosis of benign and malignant pleural effusion

作　　者：牛煊 NIU Xuan(Yellow River Sanmenxia Hospital,Sanmenxia 472000,China)

机构地区：[1]黄河三门峡医院,472000

出　　处：《中国现代药物应用》2023年第16期79-82,共4页Chinese Journal of Modern Drug Application

摘　　要：目的探讨酶学及免疫学指标对胸腔积液良恶性的鉴别诊断价值。方法回顾性分析248例胸腔积液患者的临床资料,分析患者的年龄与病因学分布情况;比较结核性胸腔积液和癌性胸腔积液患者年龄及酶学、免疫学指标[胸水腺苷脱氨酶(PADA)、胸水乳酸脱氢酶(PLDH)、胸水癌胚抗原(PCEA)和血清腺苷脱氨酶(SADA)、血清乳酸脱氢酶(SLDH)、血清癌胚抗原(SCEA)],酶学与免疫学指标比值(PADA/SADA、PLDH/SLDH、PCEA/SCEA)。结果248例患者中<45岁68例,45~65岁62例,>65岁118例。癌性胸腔积液患者共82例(33.1%),其中肺癌72例,胃癌2例,肝癌5例,胸膜间皮瘤1例,卵巢癌2例;良性胸腔积液患者154例,其中结核性94例,心力衰竭(心衰)18例,肝硬化16例,结缔组织疾病10例,肺炎16例;其他胸腔积液原因不明确12例。癌性胸腔积液患者年龄(64.6±7.5)岁、SLDH(287.5±78.5)U/L、SCEA(148.5±29.6)ng/ml、PLDH(939.2±231.4)U/L、PCEA(265.9±58.4)ng/ml均高于结核性胸腔积液患者的(44.2±6.5)岁、(126.5±32.6)U/L、(4.6±3.7)ng/ml、(166.5±49.6)U/L、(9.4±4.0)ng/ml,SADA(18.6±8.2)U/L、PADA(24.3±11.3)U/L均低于结核性胸腔积液患者的(76.5±12.5)、(149.4±22.5)U/L,差异有统计学意义(P<0.05)。癌性胸腔积液患者的PADA/SADA(1.3±0.4)低于结核性胸腔积液患者的(1.9±0.8),PLDH/SLDH(3.3±0.9)、PCEA/SCEA(1.8±0.5)均高于结核性胸腔积液患者的(1.3±0.7)、(1.0±0.3),差异有统计学意义(P<0.05)。结论结核和癌症是引起胸腔积液的主要原因,PADA、PLDH、PCEA及SADA、SLDH、SCEA有助于诊断鉴别胸腔积液的性质。Objective To discuss the value of enzymatic and immunological indices in differential diagnosis of benign and malignant pleural effusion.Methods The clinical data of 248 patients with pleural effusion were retrospectively analyzed,and the age and etiological distribution of the patients were analyzed.Comparison was made on age and enzymatic and immunological indices[pleural adenosine deaminase(PADA),pleural lactate dehydrogenase(PLDH),pleural carcinoembryonic antigen(PCEA)and serum adenosine deaminase(SADA),serum lactate dehydrogenase(SLDH),serum carcinoembryonic antigen(SCEA)],ratio of enzymatic and immunological indices(PADA/SADA,PLDH/SLDH,PCEA/SCEA)between patients with tuberculous pleural effusion and those with cancerous pleural effusion.Results Among 248 patients,68 cases were<45 years old,62 cases were 45-65 years old,and 118 cases were>65 years old.There were 82 patients(33.1%)with cancerous pleural effusion,including 72 cases of lung cancer,2 cases of gastric cancer,5 cases of liver cancer,1 case of pleural mesothelioma,and 2 cases of ovarian cancer;154 patients with benign pleural effusion,including 94 cases of tuberculosis,18 cases of heart failure(heart failure),16 cases of liver cirrhosis,10 cases of connective tissue disease,and 16 cases of pneumonia;12 cases of other pleural effusion with unclear causes.The age of(64.6±7.5)years,SLDH of(287.5±78.5)U/L,SCEA of(148.5±29.6)ng/ml,PLDH of(939.2±231.4)U/L,and PCEA of(265.9±58.4)ng/ml of patients with cancerous pleural effusion were higher than those of(44.2±6.5)years,(126.5±32.6)U/L,(4.6±3.7)ng/ml,(166.5±49.6)U/L,and(9.4±4.0)ng/ml of patients with tuberculous pleural effusion;SADA of(18.6±8.2)U/L and PADA of(24.3±11.3)U/L of patients with cancerous pleural effusion were lower than those of(76.5±12.5)and(149.4±22.5)U/L of patients with tuberculous pleural effusion;the differences were statistically significant(P<0.05).PADA/SADA of(1.9±0.8)in patients with tuberculous pleural effusion was significantly greater than that of(1.3±0.4)in patien

关 键 词：胸腔积液 结核 癌症 临床特点 酶学指标 免疫学指标 

分 类 号：R561.3[医药卫生—呼吸系统]