联合检测癌胚抗原、总胆固醇和腺苷脱氢酶对腹水性质鉴别诊断价值

目的：研究联合检测癌胚抗原（carcinoembryonic antigen，CEA）、总胆固醇（total cholesterol，Tch）和腺苷脱氨酶（adenosine deaminase，ADA）等指标对腹水性质的鉴别诊断价值。方法：将诊断明确的68例腹水分为恶性腹水、结核性腹水和非结核性良性腹水3组。检测腹水中CEA、Tch和ADA等指标。观察不同性质腹水中这3项指标的改变特点。结果：CEA在恶性腹水明显高于良性腹水，诊断恶性腹水的敏感性和特异性分别为50．0％和100．0％；结核性腹水中Tch均≥1．54mmol／L，而所有非结核性良性腹水≤1．18mmol／L，恶性腹水Tch水平多介于结核性和非结核性良性腹水之间；腹水ADA〉30u／ml者在结核性腹水中占80．0％，而非结核性良性腹水均低于此值。结论：CEA、Tch和ADA对腹水性质的诊断和鉴别诊断有重要价值，联合检测能提高腹水性质的诊断水平。

The value of simultanous eletermination of CEA,Tch and ADA in the differential diagnosis of ascites

Objectives:To study the value of simultaneous determination of carcinoembryonic antigen (CEA),total cholesterol (Tch) and adenosine deaminase (ADA) in the differential diagnosis of ascitic etiology.Method:Sixty-eight cases of ascites were divided into three groups based on their etiology, namely malignant ascites,tuberculous ascites and non-tuberculous benign ascites.CEA,Tch and ADA were measured and analyzed in different ascites.Results:CEA was significantly higher in malignant ascites than in benign ascites, the sensitivity and specificity for malignant ascites being 50.0% and 100.0% respectively. Tch is higher or equal to 1.54mmol/L in all tuberculous ascites and lower or equal to 1.18 mmol/L in non-tuberculous ascites,and Tch in malignant ascites was frequently between tuberculous and non-tuberculous benign ascites.Ascitic ADA activity was higher than 30u/ml in 80.0% of tuberculous ascites,while none of non-tuberculous benign ascites reached to such level.Conclusions:CEA,Tch and ADA are important for the diagnosis and differential diagnosis of ascitic etiology and simultaneous measurements of these indices can increase the diagnostic efficiency.