联合检测血清及胸水LDH、ADA、CEA、CA153对胸水性质的鉴别价值

目的：探讨不同项目联合检测对胸水性质的鉴别价值。方法：收集本院134例患者的胸水和血清,分为3组：A恶性胸水组30例,B结核性胸水组29例,C其他非结核良性病变组75例。同步测定胸水-血清乳酸脱氢酶（LDH）、腺苷脱氨酶（AOA）、癌胚抗原（CEA）、CA153及其各自比值。结果：恶性胸水LDH及其比值明显高于非结核良性胸水LDH（P〈0．01）,与结核性胸水LDH比较差异不大（P〉0．05）。结核性胸水ADA及其比值高于恶性胸水和非结核良性胸水,相比较差异有显著性（P〈0．01）,恶性胸水和非结核良性胸水比较差异无显著性（P〉0．05）。恶性胸水CEA高于结核与非结核良性胸水CEA（P〈0．01）,结核性胸水CEA和非结核性良性胸水CEA比较差异无显著性（P〉0．05）,CEA比值除恶性胸水与结核性胸水差异无显著性外,其它配对组均有差异。恶性胸水CA153及其比值显著高于其它两组（P〈0．01）,非结核良性胸水与结核性胸水比较差异无显著性（P〉0．05）。结论：胸水LDH、胸水／血清LDH、胸水ADA、胸水,血清ADA、胸水CEA、胸水CA153、胸水,血清CA153等指标的测定,在对胸水性质的鉴别中有较高的实用价值。     

联合血清、胸水LDH、CEA、CA153、ADA检测对胸水性质鉴别价值

目的 研究血清、胸水LDH、CEA、CA153、ADA的检测对胸水性质鉴别价值.方法 选取37例癌症患者为癌症组,42例结核患者为结核组,检测两组别血清及胸水LDH、CEA、CA153、ADA水平.结果 癌症组血清与结核组血清LDH、CEA、CA153、ADA各项经方差分析,有统计学差异(P均<0.05),癌症组胸水与结核组胸水LDH、CEA、CA153、ADA各项经方差分析,有统计学差异(P均<0.05).结论 联合血清、胸水LDH、CEA、CA153、ADA检测对胸水性质鉴别有重要的临床意义.     

联合血清、胸水LDH、CEA、CAl53、ADA检测对胸水性质鉴别价值

目的研究血清、胸水LDH、CEA、CAl53、ADA的检测对胸水性质鉴别价值。方法选取37例癌症患者为癌症组,42例结核患者为结核组,检测两组别血清及胸水LDH、CEA、CAl53、ADA水平。结果癌症组血清与结核组血清LDH、CEA、CAl53、ADA各项经方差分析,有统计学差异（P均〈0．05）,癌症组胸水与结核组胸水LDH、CEA、CAl53、ADA各项经方差分析,有统计学差异（P均〈0．05）。结论联合血清、胸水LDH、CEA、CAl53、ADA检测对胸水性质鉴别有重要的临床意义。     

ADA和LDH联合检测在结核性和恶性胸腔积液中的诊断分析

结核和肿瘤是引起渗出性胸腔积液最常见的原因。此类胸腔积液根据临床表现、胸水常规和生化检查难以确诊,尤其胸水抗酸杆菌检查阳性率低,对诊断结核性胸膜炎缺乏可靠的客观依据。本研究探讨胸水腺苷脱氨酶（ADA）和乳酸脱氢酶（LDH）在结核性胸膜炎与癌性胸膜炎鉴别诊断中的价值,对72例胸腔积液患者的胸水LDH和ADA进行检测分析,并探讨其对鉴别的临床意义。     

LDH、ADA、CEA、CRP联合检测在良恶性胸腔积液鉴别诊断中的意义

目的探讨乳酸脱氢酶（LDH）、腺苷脱氨酶（ADA）、癌胚抗原（CEA）、C反应蛋白（CRP）在良恶性胸腔积液鉴别诊断中的意义。方法使用AU2700全自动生化分析仪用速率法测定LDH、ADA,用免疫比浊法测CRP,用电化学发光法测CEA。按《肺结核诊断与治疗指南》的相关标准将100例胸腔积液患者分为结核性胸腔积液组和恶性肿瘤性胸腔积液组,分别为良性和恶性胸腔积液组,每组50例患者。结果恶性胸腔积液组CRP、ADA水平明显低于良性胸腔积液组（P〈0.05）,LDH、CEA水平明显高于良性胸腔积液组（P〈0.05）。结论 LDH、ADA、CEA、CRP联合检测有助于对良恶性胸腔积液进行鉴别诊断。     

胸水ADA、LDH、CEA检测在胸腔积液中的鉴别诊断价值

目的探讨胸水腺苷脱氨酶(ADA)、乳酸脱氢酶(LDH)和癌胚抗原(CEA)检测在胸腔积液鉴别诊断中的价值。方法对32例恶性胸腔积液的患者和40例结核性胸腔积液患者的ADA、LDH、CEA进行定量分析。结果 ADA在结核性胸腔积液组中明显升高(P<0.01)、而CEA在恶性胸腔积液组中(P<0.01)、LDH在两组中均升高,但恶性组中升高明显。结论 ADA、LDA、CEA的联合检测对积水性胸腔积液和恶性胸腔积液的鉴别诊断有重要的临床价值。     

联合检测ADA、CEA、LDH、TB—Ab和CA199在结核性与癌性胸水鉴别诊断中的价值

目的探讨胸水和血清中腺苷脱氨酶（ADA）、癌胚抗原（CEA）、乳酸脱氢酶（LDH）、结核抗体（TB—Ah）和糖抗原199（CA199）对结核性胸水和癌性胸水的鉴别诊断。方法检测经确诊的患者的胸水和血清中ADA、CEA、LDH、TB-Ab和CA199的含量。结果CEA、LDH、CA199诊断癌性胸水的敏感性分别是75．6％、75．6％、73．1％；特异性是88．0％、89．3％、90．7％。ADA、TB．Ab诊断结核性胸水的敏感性分别是73．3％、62．67％；特异性是90．2％、90．2％。五项联合检测其敏感性是78．0％，特异性是93．3％。结论ADA、CEA、LDH、TB—Ab和CA199联合检测对结核性胸水和癌性胸水有较高的鉴别诊断价值。     

腹水ADA、TC及LDH水平对结核性腹水及恶性腹水的诊断价值

目的 探讨腹水中腺苷脱氨酶(ADA)、TC及乳酸脱氢酶(LDH)诊断结核性腹水及恶性腹水的应用价值.方法 检测结核性腹水组(21例)、非结核性良性腹水组(46例)和恶性腹水组(44例)患者腹水中ADA、TC及LDH水平,绘制ROC曲线,分析相关指标对结核性腹水及恶性腹水的诊断价值.结果 结核性腹水组ADA水平高于非结核性腹水组(恶性腹水组+非结核性良性腹水组)(51.50 U/L vs.6.05 U/L) (P＜0.01).结核性腹水组和恶性腹水组腹水TC水平为(2.54±0.80) mmol/L和(2.47±0.76) mmol/L,LDH水平为243.00 U/L和215.00 U/L,均高于非结核性良性腹水组的(0.76±0.55) mmol/L和57.00 U/L(P＜0.05).当腹水ADA水平为30.05 U/L时,其对结核性腹水的诊断灵敏度为95.2％,特异度为96.7％;当腹水TC水平为1.25 mmol/L时,其对结核性或恶性腹水的诊断灵敏度为96.9％,特异度为89.1％;当腹水LDH水平为103.5 U/L时,其对结核性或恶性腹水的诊断灵敏度为93.8％,特异度为89.1％.结论 腹水ADA对结核性腹水有特异性诊断价值,腹水TC及LDH对结核性腹水及恶性腹水有诊断价值.     

联合检测胸水ADA、CEA、CA125、CA153在结核性与恶性胸水中的鉴别诊断价值

目的探讨联合检测胸水ADA、CEA、CA125、CA153对结核性与恶性胸水的鉴别诊断价值。方法收集114例已确诊胸腔积液患者的胸水,其中恶性组胸水64例,结核性胸水50例,检测两组患者胸水ADA、CEA、CA125、CA153水平。结果恶性组ADA明显低于结核组,而CEA、CA125、CA153水平明显高于结核组,两者差异显著,具有统计学意义。CEA、CA125、CA153对恶性胸水诊断的敏感性分别为73.4%、81.2%、43.8%,特异性分别为84.0%、46.0%、88.0%,准确性分别为79.8%、63.2%、66.7%,三项联合检测可显著提高诊断敏感性(93.4%)。ADA对结核性胸水的敏感性、特异性、准确性分别为83.4%、91.5%、87.6%。结论联合检测胸水ADA、CEA、CA125、CA153有助于结核性与恶性胸水的鉴别诊断。     

联合检测TB-Ab、ADA和CEA对鉴别结核性和恶性胸水的诊断价值

目的评价联合检测胸水中结核抗体（TB-Ab）、腺苷脱氨酶（ADA）、癌胚抗原（CEA）对结核性和恶性胸水的诊断价值。方法采用金标免疫斑点渗滤试验、酶速率法和酶联免疫法对212例患者胸水进行TB-Ab、ADA和CEA检测分析。结果胸水中TB-Ab、ADA和CEA的阳性率分别为：结核性胸水（182例）61.5%、75.8%和2.7%,恶性胸水（30例）6.7%、13.3%和86.7%。结论联合检测TB-Ab、ADA和CEA三项指标对鉴别诊断结核性和恶性胸水具有较高的临床应用价值。     

C-反应蛋白在结核性与肿瘤性胸腔积液鉴别中的意义

目的:探讨胸水及血清中C-反应蛋白(CRP)在结核及肿瘤性胸腔积液鉴别诊断中的价值。方法:使用免疫比浊法,对116例胸腔积液患者同时测定胸水及血清中CRP浓度,并评价其结果。结果:结核组及肿瘤组胸水中CRP浓度分别为28. 70±13. 30mg·L-1和10. 02±8. 2mg·L-1,两组胸水CRP/血清CRP比值分别为1. 81±0. 70和0. 82±0. 21,两者相比差异显著(P<0. 01)。结论:CRP在结核性与肿瘤性胸腔积液鉴别中有一定价值。     

联合检测乳酸脱氢酶和腺苷脱氨酶对结核性胸腔积液的诊断价值

目的探讨联合检测乳酸脱氢酶(LDH)和腺苷脱氨酶(ADA)对结核性胸腔积液的诊断价值。方法 186例胸腔积液患者分为结核组75例和非结核组111例,分别进行血浆和胸腔积液LDH和ADA检测。结果结核组血浆和胸腔积液LDH及ADA水平均高于非结核组,差异均有统计学意义(P<0.05)。结论血清和胸腔积液LDH、ADA联合检测,对临床结核性胸膜炎的诊断具有较高价值。     

腺苷脱氨酶、乳酸脱氢酶、癌胚抗原、肿瘤抗原19-9、肿瘤抗原125联合检测鉴别良恶性胸腔积液

目的探讨胸腔积液中腺苷脱氨酶（ADA）、乳酸脱氢酶（LDH）、癌胚抗原（cEA）、肿瘤抗原19—9（CA19—9）、肿瘤抗原125（CA125）联合检测在胸腔积液鉴别诊断中的意义。方法常规采集各80例结核性疾病组和恶性疾病组胸腔积液，测定胸腔积液ADA、LDH、CEA、CA125、CA19—9等五项指标，并进行对比分析。结果联合检测对结核性胸腔积液诊断的敏感度为92．5％、特异度为93．6％、准确度为92．7％；对恶性胸腔积液诊断的敏感度、特异性、准确度分别为92．3％、94．6％、93．5％。结论联合检测多项指标有效地避免了单一指标检测所致的误诊和漏诊，有助于胸腔积液的病因诊断。     

Update on Talc,Bleomycin, and the Tetracyclines in the Treatment of Malignant Pleural Effusions

Talc has been used to treat malignant pleural effusions (MPE) for over 30 years and is usually considered to be the most effective chemical agent for pleurodesis. Clinicians, aware of limited reports of serious adverse effects attributed to talc, have generally reserved it for selected patients who are refractory to first-line chemical sclerosants. Tetracycline and bleomycin have therefore been cited as the preferred agents for the treatment of MPE. Clinical studies reported over the last 5 years reflect a continuing interest in talc as a chemical sclerosant and provide evidence of its effectiveness with minimal side effects. Comparisons with other agents are necessary to evaluate further the application of talc insufflation in the thoracoscopy suite and talc slurry at the patients bedside. As clinicians continue to debate the relative merits of various pleurodesis agents, talc appears to be a reasonable choice for the treatment of MPE.     

深部热疗联合胸腔灌注化疗治疗恶性胸腔积液的观察及护理

目的探讨胸腔置管引流并腔内灌注化疗药物联合深部热疗治疗恶性胸腔积液的疗效及护理。方法 60例恶性胸腔积液患者均采用中心静脉导管作胸水引流,胸腔内交替注入顺铂、白细胞介素-II,每周1～2次,联合胸部热疗,隔日1次,6次为1个疗程,治疗中配合相应的护理。结果 60例患者均能耐受治疗,完成1～3个疗程,有2例出现堵管,1例热疗时出现皮肤红斑,其余无严重并发症。结论深部热疗联合胸腔内灌注化疗已成为治疗恶性胸腔积液的有效方法,做好治疗中引流管的护理和热疗的护理,减少不良反应,防止并发症,是持续治疗的重要环节。疗效     

Elevated lactate dehydrogenase activity and increased cardiovascular mortality in the arsenic-endemic areas of southwestern Taiwan

Arsenic ingestion has been linked to increasing global prevalence of and mortality from cardiovascular disease (CVD); arsenic can be removed from drinking water to reduce related health effects. Lactate dehydrogenase (LDH) is used for the evaluation of acute arsenic toxicity in vivo and in vitro, but it is not validated for the evaluation of long-term, chronic arsenic exposure. The present study examined the long-term effect of chronic arsenic exposure on CVD and serum LDH levels, after consideration of arsenic metabolism capacity. A total of 380 subjects from an arseniasis-endemic area and 303 from a non-endemic area of southwestern Taiwan were recruited in 2002. Various urinary arsenic species were analyzed using high-performance liquid chromatography (HPLC) and hydride generation systems. Fasting serum was used for quantitative determination of the total LDH activity. A significant dose-response relationship was observed between arsenic exposure and LDH elevation, independent of urinary arsenic profiles (P < 0.001). Furthermore, abnormal LDH elevation was associated with CVD mortality after adjustment for Framingham risk scores for 10-year CVD and arsenic exposure (hazard ratio, 3.98; 95% confidence interval, 1.07-14.81). LDH was elevated in subjects with arsenic exposure in a dose-dependent manner. LDH is a marker of arsenic toxicity associated with CVD mortality. Results of this study have important implications for use in ascertaining long-term arsenic exposure risk of CVD.     

Effects of lead,copper, and zinc on the rat's lactate dehydrogenase in vivo and in vitro

Following subacute intoxication of rats with Pb-, Cu-, and Zn-salts (separately or in mixture) for 5 weeks, the chelating agent D-penicillamine was administered for 3 weeks. In the course of the 3-month experiment, lactate dehydrogenase (LDH) was estimated in serum and in cytoplasmic fraction of the kidney. Pb²⁺ treatment resulted in an increase of LDH activity, Cu²⁺ in a slight decrease, whereas Zn²⁺ had no effect, respectively. Mixture of these metals caused a significant rise in the enzymatic activity. Seven weeks after the stoppage of the administration of toxic substances, altered LDH activity, both in serum and in kidney returned to normal. D-penicillamine treatment was found to accelerate a restoration of the enzyme activity.In the experiments in vitro, Cu²⁺ inhibited significantly the kidney LDH activity, Pb²⁺ and Zn²⁺ being 100- and 400-times less efficient, respectively. Cu²⁺ inhibition was reversed by D-penicillamine, whereas inhibition of LDH by Zn²⁺ or Pb²⁺ was irreversible.     

Effects of 1-(2,6-dimethylphenoxy)-2-(3,4-dimethoxyphenylethylamino)propane hydrochloride on heartfunction,lactate dehydrogenase and its isoenzymes in rats with cardiac hypertrophy

目的：研究１（２，６二甲基苯氧基）２（３，４二甲氧基苯乙氨基）丙烷盐酸盐（ＤＤＰＨ）对心肌肥厚大鼠心功能及乳酸脱氢酶（ＬＤＨ）及其同工酶的影响．方法：部分狭窄腹主动脉，术后４周，大鼠给予ＤＤＰＨ．结果：ＤＤＰＨｉｇ４周明显改善大鼠心功能．各组ＬＤＨ活性及ＬＤＨ２无明显差异，但心肌肥厚组ＬＤＨ３，ＬＤＨ４，ＬＤＨ５，特别是ＬＤＨ５增加，而ＬＤＨ１下降．Ｍ亚基是对照组的１６９倍，ＤＤＰＨ明显逆转上述变化．结论：ＤＤＰＨ改善心肌肥厚时下降的心功能，同时逆转ＬＤＨ同工酶谱的变化．     

An in vitro comparative study upon the toxic properties of the venoms from Hemiscorpius lepturus, Androctonus crassicauda and Mesobuthus eupeus scorpions

The aim of the present study was to compare the toxic effects of the venoms from Hemiscorpius lepturus (H. lepturus), Androctonus crassicauda (A. crassicauda) and Mesobuthus eupeus (M. eupeus). For this purpose, three in vitro models were employed to compare the toxic effects of various concentrations of the venoms from these three scorpions, namely: hemolytic potential using human RBCs, phospholipase activity using Saubouraud's dextrose agar (SDA) supplemented with 2% egg yolk and lactate dehydrogenase (LDH) enzyme releasing effect using K562 leukemia cell line. In addition, the neutralizing effectiveness of the antivenom against these toxic properties was assessed. The results showed that, unlike the venoms from A. crassicauda and M. eupeus, the venom from H. lepturus produced dose-dependent lysis of human RBCs and showed phospholipase activity. However, all the tested venoms showed variable degrees of LDH releasing properties. The venom from H. lepturus had highest and the venom from M. eupeus had the lowest LDH releasing effect. The antivenom effectively inhibited all the tested toxicities. In conclusion, these results suggest that the venoms from the studied scorpions have variable toxic properties, which may explain the underlying reason for the differences in their clinical manifestations. In addition, the antivenom was effective in neutralizing all the tested toxic effects.