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。

The value of the measurement of C-reactive protein in the differentiation of the nature of hydrothoratic and ascitic fluid.

Objective To investigate the value of distinguishing between exudate and transudate in hydrothorax and ascites by the measurement of serosamucin, specific gravity(SG) and C-reactive protein(CRP). Methods Serosamucin(Rivalta test) and SG were determined protein in 134 samples(hydrothorax or ascites) and compared with CRP determined by nephelometric immunoassay in 34 hydrothorax or ascites and sera. Results In 73 exudate,19 transudate and 42 indifferentiated.The level of CRP in both hydrops and serum were significantly higher in exudate group than in transudate group(P<0.001).The sensitivity,specificity and accuracy of CRP were higher than routine method. Conclusions The measurement of CRP in both hydrops and serum is helpful to distinguish between exudate and transudate,but to measure also serosamucin and SG can get more significant value in identifying the nature of hydrops and more useful in the diagnosis,treatment and prognosis.