联合检测CEA、Tch和ADA对腹水病因的鉴别诊断价值

目的 :研究联合检测腹水中癌胚抗原 (CEA)、总胆固醇 (Tch)和腺苷脱氨酶 (ADA)等指标对腹水病因诊断和鉴别诊断的价值。方法 :根据病因将 6 8例腹水患者分为恶性腹水、结核性腹水和非结核性良性腹水三组。检测和分析不同腹水中CEA、Tch和ADA等指标的特点。结果 :CEA在恶性腹水组中明显高于良性腹水组 ,诊断恶性腹水的敏感性和特异性分别为 5 0 %和 10 0 %。Tch在结核性腹水组中(1.5 4mmol L ,而在非结核良性腹水组中≤ 1.18mmol L ,恶性腹水组的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者在结核性腹水组中占 80 % ,而非结核性良性腹水组的患者均低于此值。结论 :CEA、Tch和ADA对腹水病因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。

Combined Determination of CEA, Tch and ADA for Differential Diagnosis of Ascites

Objective: To study the value of combined determination of carcinoembryonic antigen (CEA), total cholesterol (Tch) and adenosine deaminase (ADA) in the differential diagnosis of ascites due to different causes. Methods: Sixty-eight cases with ascites were divided into 3 groups based on their etiology, namely malignant ascites, tubercular ascites and non-tubercular 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% and 100% respectively. Tch is higher or equal to 1.54 mmol/L in tubercular ascites and lower or equal to 1.18 mmol/L in non-tubercular benign ascites, and Tch level in malignant ascites was frequently between that in tubercular acites and non-tubercular benign ascites. Ascitic fluid ADA activity was higher than 30 U/L in 80% of tubercular ascites, while none of non-tubercular benign ascites reached to such level. Conclusion: CEA, Tch and ADA are valuable for the diagnosis and differential diagnosis of ascitic etiology and combine measurements of these indices can increase the diagnostic efficiency.