心钠素测定在良恶性胸腔积液鉴别中的价值

目的探讨胸腔积液心钠素水平在良、恶性胸腔积液鉴别中的价值。方法采用放射免疫直接测定法，测定３０例结核性和２６例癌性胸腔积液患者胸腔积液及血清心钠素水平。结果结核性、癌性胸腔积液心钠素水平分别为（７５±９）ｎｇ／Ｌ、（１５７±４５）ｎｇ／Ｌ，两者有极显著性差异（Ｐ＜０．００１）；结核性胸腔积液心钠素水平［（７５±９）ｎｇ／Ｌ］明显低于血清心钠素水平［（１７０±３７）ｎｇ／Ｌ］，差异有极显著性意义（Ｐ＜０００１）；结核性与癌性胸腔积液患者胸腔积液与血清心钠素水平之比值分别为０４７±０１７、０９９±０４６，两者差异有极显著性意义（Ｐ＜０００１）；其对恶性胸腔积液诊断的敏感性及特异性分别为８１％和１００％。结论测定胸腔积液心钠素水平是良、恶性胸腔积液鉴别的重要方法之一

Evaluation of atrial natriuretic peptide in differentiating benign and malignant pleural effusion

OBJECTIVE: To discuss the value of atrial natriuretic peptide (ANP) in differentiating benign and malignant pleural effusion. METHODS: Direct radioimmunoassay was used to detect ANP of pleural effusion and serum in 30 tuberculous and 26 cancerous pleural effusion patients. RESULTS: The ANP in tuberculous and cancerous pleural effusion were (75 +/- 9) ng/L, (157 +/- 45) ng/L respectively, and significant difference was found (P < 0.001). The ANP of tuberculous pleural effusion was apparently lower [(75 +/- 9) ng/L] than serum [(170 +/- 37) ng/L], and significant difference was also found (P < 0.001). The ratio of ANP of pleural effusion to that of serum were 0.47 +/- 0.17, 0.99 +/- 0.46 respectively in tuberculous and cancerous pleural effusion patients. The sensitivity of ANP was 81% and specificity 100% in diagnosing malignant pleural effusion. CONCLUSIONS: Detecting ANP of pleural effusion is one of important methods for differentiating benign and malignant pleural effusion.