C反应蛋白检测在判断胸腹水积液性质中的价值

目的了解黏蛋白、比密（SG）检测与C-反应蛋白（CRP）在判断胸腹水渗出液／漏出液中的关系及诊断价值。方法134例胸腹腔积液采用黏蛋白定性（即Rivalta试验）、SG与免疫比浊法测定积液及血清中CRP水平，进行比对。结果用常规方法测定黏蛋白、SG，并以此判断出134例胸腹腔积液中渗出液为73例，漏出液为19例，不确定组为42例；积液及血清CRP定量测定渗出液组明显高于漏出液组（P均〈0．01）。其敏感度、特异度及准确度均高于常规方法。结论积液和血清CRP检测有助于临床鉴别渗出液和漏出液，但用经典的Rivalta试验、SG测定再同时检测积液或血清CRP并进行综合判断积液的性质将对疾病的诊断、治疗和预后有更雷女的音口     

C反应蛋白检测在判断胸腹水积液性质中的价值

目的了解黏蛋白、比密(SG)检测与C-反应蛋白(CRP)在判断胸腹水渗出液/漏出液中的关系及诊断价值。方法134例胸腹腔积液采用黏蛋白定性(即R ivalta试验)、SG与免疫比浊法测定积液及血清中CRP水平,进行比对。结果用常规方法测定黏蛋白、SG,并以此判断出134例胸腹腔积液中渗出液为73例,漏出液为19例,不确定组为42例;积液及血清CRP定量测定渗出液组明显高于漏出液组(P均<0.01)。其敏感度、特异度及准确度均高于常规方法。结论积液和血清CRP检测有助于临床鉴别渗出液和漏出液,但用经典的R i-valta试验、SG测定再同时检测积液或血清CRP并进行综合判断积液的性质将对疾病的诊断、治疗和预后有更重大的意义。     

C-反应蛋白检测在鉴别胸腹水性质中的临床价值

目的 了解胸腹腔积液C-反应蛋白(CRP)检测与乳酸脱氢酶(LDH)、总蛋白在判断胸腹水渗出液/漏出液中的关系.方法 110例胸腹腔积液测定其总蛋白、总蛋白/血清总蛋白、LDH、LDH/血清LDH与免疫比浊法测定积液中CRP水平,进行比对评价.结果 根据Light标准判断出110例胸腹腔积液中渗出液为71例,漏出液为39例;积液中CRP定量测定渗出液组明显高于漏出液组(P＜0.01).其具有较高敏感度,特异度及准确度.结论 胸腹腔积液CRP定量测定有助于临床鉴别渗出液与漏出液的性质,与Light判断标准同时检测积液中的CRP并进行综合判断,将对疾病的诊断、治疗和预后有更大的临床意义.     

用C-反应蛋白鉴别胸腹水的性质

本文通过对89例患者胸腹腔积液C—反应蛋白(CRP)的测定,来鉴别漏出液与渗出液,结果如下.1.对象本院收治的89例胸腹腔积液患者,其中胸腔积液42例,腹腔积液47例。按性质分为三组:(1)漏出液心力衰竭8例,晚期肝硬化28例,晚期再     

过氧化物酶定性试验鉴别胸腹水性质

胸、腹腔积液(胸水、腹水等)性质(漏出液,渗出液)的鉴别有助于揭示积液的病因。近年来常规检查内容不断增加,除Rivalta反应、蛋白质、葡萄糖、细胞、细菌等检测外,有的实验室已新增乳酸脱氢酶,甚至CRP、纤维蛋白原及其降解产物、腺苷脱氨酶(ADA)、淀粉酶以及肿瘤标志物(CEA、AFP、hCG等),我们发现用过氧化物酶(peroxidase,PO)定性     

应用ROC曲线确定胸腹水铁蛋白及其与血清铁蛋白比值鉴别胸腹水性质的诊断界限

胸腹水铁蛋白(p leural-peritonreal effusion ferritin,PFt)及其与血清铁蛋白(serum ferritin,SFt)比值(PFt/SFt)用于鉴别胸腹水是渗出液还是漏出液受到国内外学者的关注[1~3],2项实验指标诊断界限的确定(临界点)决定其应用的准确性。受试者工作特征曲线(rece iver operatingcharacteristic curve,ROC曲线)在临床诊断性检验中,常用于判断临界点的正确选择[4]。我们用放射免疫分析法对218份临床诊断明确,由不同病因引起的胸腹水标本及其同期血清标本进行铁蛋白(ferritin,Ft)含量测定,用ROC曲线选择PFt、PFt/SFt2项指标用于鉴别渗出…     

C-反应蛋白及铁蛋白检测在判断胸腹水性质中的应用

目的探讨C-反应蛋白、铁蛋白检测在判断胸腹水性质中的价值。方法对100例胸腹水（渗出液75例、漏出液25例）患者,采用美国奥林帕斯AU-2700全自动生化分析仪进行C-反应蛋白测定,采用BACKMANCOULTER Access2全自动发光仪进行铁蛋白测定。结果漏出液中C-反应蛋白和铁蛋白的含量分别为（3.4±1.3）mg·L-1和（75.3±34.2）μg·L-1,渗出液中C-反应蛋白和铁蛋白的含量分别为（18.1±7.5）mg·L-1和（269.8±74.3）μg·L-1,渗出液中C-反应蛋白和铁蛋白的含量明显高于漏出液（均P〈0.01）。结论 C-反应蛋白与铁蛋白在渗出液与漏出液中的含量存在显著差异,其检测有助于鉴别渗出液和漏出液。     

胸水胆固醇和尿酸在鉴别渗出液和漏出液中的价值

目的探讨胸水胆固醇(Pch)浓度、胸水与血清胆固醇(Sch)浓度的比值(P/Sch)、胸水尿酸(Pua)浓度对胸腔积液渗漏性的鉴别诊断价值.方法对85例胸腔积液患者检测Pch和65例患者检测Pua,并计算出P/Sch,分别研究Pch、P/Sch、Pua、胸水总蛋白(Ptpr)对胸水渗漏性诊断的受试者工作特征曲线(ROC)、灵敏度、特异性与诊断效率.结果 Pch、P/Sch、Pua、Ptpr对胸水渗出液诊断的灵敏度分别为96.2%、90.4%、79.5%和90.6%,特异性分别为100.0%、89.7%、61.9%和80.6%.Pch鉴别渗出液和尿酸鉴别漏出液的ROC曲线下面积分别是0.986和0.655.结论 Pch、P/Sch、Ptpr对胸水渗出液具有较高的鉴别诊断价值,ROC亦证明Pch鉴别渗出液和Pua监测漏出液是可行的,Pch的诊断效率最高(P＜0.05).Pua对胸水监测漏出液有一定价值,尿酸增加表示机体抗氧化状态佳,提示预后较好.     

胸水胆固醇和尿酸在鉴别渗出液和漏出液中的价值

目的　探讨胸水胆固醇(Pch)浓度、胸水与血清胆固醇(Sch)浓度的比值(P/Sch)、胸水尿酸(Pua)浓 度对胸腔积液渗漏性的鉴别诊断价值。方法　对85例胸腔积液患者检测Pch和65例患者检测Pua,并计算出 P/Sch,分别研究Pch、P/Sch、Pua、胸水总蛋白(Ptpr)对胸水渗漏性诊断的受试者工作特征曲线(ROC)、灵敏度、 特异性与诊断效率。结果　Pch、P/Sch、Pua、Ptpr对胸水渗出液诊断的灵敏度分别为96.2%、90.4%、79.5%和 90.6%,特异性分别为100.0%、89.7%、61.9%和80.6%。Pch鉴别渗出液和尿酸鉴别漏出液的ROC曲线下面 积分别是0.986和0.655。结论　Pch、P/Sch、Ptpr对胸水渗出液具有较高的鉴别诊断价值,ROC亦证明Pch鉴 别渗出液和Pua监测漏出液是可行的,Pch的诊断效率最高(P<0.05)。Pua对胸水监测漏出液有一定价值,尿 酸增加表示机体抗氧化状态佳,提示预后较好。     

胸腹水与血清中前清蛋白的联合检测及意义

目的 探讨患者胸腹水和血清中前清蛋白(PA)测定对良、恶性胸腹水以及渗出液、漏出液鉴别的意义.方法 将82例患者的胸腹水标本分为2组,良性胸腹水组43例,恶性胸腹水组39例;根据胸腹水形成原因又将82例胸腹水标本分为渗出液组和漏出液组,渗出液组51例,漏出液组31例,分别测定患者的胸腹水标本和血清标本中的PA浓度,并对检测结果进行比较分析.结果 良性胸腹水组和恶性胸腹水组中的PA浓度和胸腹水、血清PA浓度比值的差异均无统计学意义(P>0.05);漏出液组的PA浓度和胸腹水、血清PA浓度比值均明显低于渗出液组,差异有统计学意义(P＜0.05).结论 胸腹水标本与血清标本中PA测定对渗出液和漏出液的鉴别具有一定的价值.     

胸腹腔积液CRP与生化指标测定的临床意义

目的探讨胸腹腔积C反应蛋白（CRP）、生化指标在鉴定胸腹腔积液性质中的临床意义及其相关性。方法收集63例胸腹腔积液，采用金标法做CRP定量检测与采用BECKMAN COUL LX20全自动生化仪做生化指标定量检测，结合临床诊断进行统计学分析处理。结果渗出性胸腹腔积液自动生化仪中CRP、乳酸脱氢酶（LDH）、总蛋白（TP）、腺苷脱胺酶（ADA）水平明显高于漏出液（P〈0．01），葡萄糖（GLU）水平低于漏出液（P〈0．05），差异有统计学意义。CRP与LDH、GLU、TP、ADA有一定相关性。结论CRP、LDH、GLU、TP、ADA浓度测定对鉴别胸腹水性质有一定临床价值。     

白蛋白梯度在鉴别渗出液和漏出液和漏出液中的价值

目的 用红蛋白梯度来鉴别积液是漏出液还是渗出液。方法 用化学法测定50例积液患者的血清与积液中总蛋白（Total protein,TP）和白蛋白的值。结果 血清白蛋白,积液白蛋白,血清/积液白蛋白比值和血清/积液白蛋白差值（梯度）在渗出液和漏出液中差异均存在显著性,尤其是血清/积液白蛋白差值的诊断灵敏度为81.5％,诊断特异度为87%,诊断准确度为84%,阳性预测值为88%,阴性预测值为80%。结论 定量测定血清和积液白蛋白对于鉴别漏出液和渗出液有很好的性能,且方法简便,易于在各基层单位推广使用。     

Differentiation of exudate from transudate ascites by Doppler sonography

Background: We investigated whether the addition of Doppler sonography (US) increases the diagnostic confidence of US for estimating the nature of ascites.Methods: Of the 127 cases reviewed in this study, there were 42 cases of transudate and 85 of exudate ascites. We reviewed the US, power Doppler, and pulsed Doppler images of these cases.Results: With US, the transudate ascites was imaged as free of echo in 38 of 42 cases (90.5%). The exudate ascites was imaged as free of echo in 22 of 85 cases (25.9%) and with internal echo spots in 63 of 85 cases (74.1%). With Doppler US, we obtained distinct pulsed signals from the transudate ascites in only two of 36 cases (5.6%). In contrast, we obtained distinct Doppler signals from the exudate ascites in 66 of 79 cases (83.5%). Those 66 cases included 16 of the 22 cases with echo-free ascites.Conclusion: The presence or absence of echo spots within the ascites helped differentiate transudate from exudate ascites, as reported in the literature. However, the addition of Doppler US contributed to the differentiation of echo-free exudate (Doppler signals present) from echo-free transudate (Doppler signals absent) ascites.     

Differentiation of exudate from transudate ascites based on the dipstick values of protein,glucose, and pH

The aim of present study was to determine the reliability of the dipstick values (protein, glucose, and pH) for differentiation of exudate from transudate ascites in comparison with the serum-ascites albumin gradient as criterion standard. A total of 100 patients with ascites (58 males and 42 females; mean age, 55.6 ± 16.1 years) were studied for the different causes of ascites. Peripheral blood samples were obtained, and at the same time, the patients underwent paracentesis. There were 62 cases (62.0%) of transudate ascites and 38 (38.0%) of exudates ascites, based on serum-ascites albumin gradient. Using logistic regression, we found a dipstick equation (K = 0.012Protein − 0.012Glucose − 3.329pH + 23.498) to differentiate transudate (K < 0) from exudate (K > 0) ascites. The sensitivity, specificity, positive predictive value, and negative predictive value of dipstick equation to diagnose ascites as transudate and exudate were 93.8%, 94.4%, 96.8%, and 89.5%, respectively, and 94.4%, 93.9%, 89.5%, and 96.9%, respectively. The area under the receiver operating characteristic curve was 0.915 (95% confidence interval, 0.848-0.982; P < .001). We concluded that the dipstick can be an inexpensive, rapid, and simple option for categorizing ascites into transudate and exudate and can be used routinely for this purpose in clinical practice.     

Pharmacokinetics (PK), pharmacodynamics (PD), and PK-PD integration of danofloxacin in sheep biological fluids

The fluoroquinolone antimicrobial drug danofloxacin was administered to sheep intravenously (i.v.) and intramuscularly (i.m.) at a dose of 1.25 mg/kg of body weight in a two-period crossover study. The pharmacokinetic properties of danofloxacin in serum, inflamed tissue cage fluid (exudate), and noninflamed tissue cage fluid (transudate) were established by using a tissue cage model. The in vitro and ex vivo activities of danofloxacin in serum, exudate, and transudate against a pathogenic strain of Mannheimia haemolytica were established. Integration of in vivo pharmacokinetic data with the in vitro MIC provided mean values for the area under the curve (AUC)/MIC for serum, exudate, and transudate of 60.5, 85.6, and 45.7 h, respectively, after i.v. dosing and 55.9, 77.9, and 49.1 h, respectively, after i.m. dosing. After i.m. dosing, the maximum concentration/MIC ratios for serum, exudate, and transudate were 10.8, 3.0, and 1.6, respectively. The ex vivo growth inhibition data after i.m. dosing were fitted to the inhibitory sigmoid E(max) equation to provide the values of AUC/MIC required to produce bacteriostasis, bactericidal activity, and elimination of bacteria. The respective values for serum were 17.8, 20.2, and 28.7 h, and slightly higher values were obtained for transudate and exudate. It is proposed that use of these data might provide a novel approach to the rational design of dosage schedules.     

Diagnostic value of uric acid to differentiate transudates and exudates.

Uric acid is known to be an end product of purine metabolism. Increases in uric acid may be found in clinical conditions associated with tissue hypoxia. We have investigated the value of uric acid to differentiate between a transudate and exudate. In this study, we measured uric acid in the pleural fluid and the serum of 110 patients, 30 women and 80 men with a mean age of 49.5+/-19 years. Light's criteria were used to differentiate between a transudate and exudate. Mean serum uric acid was 496.7+/-153.4 micromol/l in patients with transudates and 291.3+/-143.1 micromol/l in patients with exudates. Mean pleural fluid uric acid was 487.7+/-165 micromol/l in patients with transudates and 279.9+/-142.1 micromol/l in patients with exudates. These data showed that the levels of serum and pleural uric acid were higher in transudates than exudates (p<0.01). However, there was no significant difference between pleural fluid/serum uric acid ratio of the two patient groups (p>0.05). The specificity and sensitivity of pleural uric acid for diagnosis of transudate effusions were 73% and 80.6%, respectively. The specificity and sensitivity of pleural uric acid for diagnosis of transudate effusions from exudates without malignancy were 71.8% and 91.7%, respectively. The sensitivity and specificity of pleural lactate dehydrogenase for diagnosis of exudates were 82% and 89%; the sensitivity and specificity of pleural fluid/serum lactate dehydrogenase were 85% and 89%; the sensitivity and specificity of pleural fluid/serum protein were 91% and 89%, respectively. Using all three of Light's criteria together, the sensitivity was 91% and its specificity was 94%. Our findings indicate that determination of uric acid in pleural fluid may be of diagnostic value in differential diagnosis of transudates and exudates. The sensitivity of pleural uric acid measurement was higher for exudates without malignancy. However, Light's criteria remain the best means of separating transudates from exudates.     

胸、腹水中测定G-CSF的意义

目的观察胸、腹水中G—CH的水平及意义。方法应用中国医学科学院生产的粒细胞集落刺激因子（G—CSF）酶联免疫检测试剂盒对140例胸、腹水标本中G－CSF水平进行检测。结果漏出液组60例，G－CSF阳性检出度为3．3％，渗出液组80例，G－CH阳性检出率为77．5％，经x2检验具有显著性差异，且渗出液阳性标本WBC＞2．0X109／L，以中性粒细胞为主，提示感染性胸、腹水，渗出液18例阴性标本中，WBC计数在0．5—1.2X109／L之间，分类以淋巴细胞为主，提示非感染性渗出液。结论检测胸、腹水中的G－CSF可以鉴别渗出液和漏出液，且可作为诊断感染性渗出浓的重要依据。     

应用ROC曲线图评价几项生化指标在胸水中的价值

目的 评价TP、TPR等几项生化指标在胸水中的价值.方法 应用ROC曲线图评价74例患者胸水渗出液和漏出液中的TPR、LDHR、CHOLR等.结果 TP、LDH、CHOL及TPR、LDHR、CHOLR渗出液组均显著高于漏出液组（P＜0.01）.根据ROC曲线,所有测试中TPR的特异性和灵敏度均高于其他指标,其诊断准确性是最高的（94.8%）.根据疾病分组,除LDH在各组间无显著性差异外,其他指标组间比较均有统计学意义（P＜0.05）.结论 胸水与血清的蛋白比值（TPR）、胸水乳酸脱氢酶（LDH）、胸水胆固醇（CHOL）含量对区分胸水渗出液和漏出液以及鉴别胸水疾病的性质方面具有临床意义,特别是胸水与血清的蛋白比值（TPR）对区分胸水渗出液和漏出液更有意义.