胸水ADA与LDH检测在鉴别恶性与结核性渗出性胸水中的作用

目的:评价胸腔积液腺苷脱氨酶(ADA)、乳酸脱氢酶(LDH)在支气管肺癌胸水及结核性胸水的诊断价值。方法:对119例患者(支气管肺癌54例,结核性65例),每例均检测患者胸水ADA和LDH。结果:肺癌患者胸水LDH水平显著高于结核组(P<0.001),而其ADA显著低于结核患者(P<0.001)。胸水ADA与LDH联合检测,对肺癌所致胸水判别正确率为96.3%。结论:高PLDH和低PADA水平提示恶性胸水,仅有高水平PADA是结核性胸水的特征。

Role of pleural adenosine deaminase and pleural lactate dehydrogenase tests in the diagnosis of exudative pleural effusions

Objective: To examine the diagnostic utility of pleural adenosine deaminase (PADA), pleural lactate dehydrogenase (PLDH) tests in bronchogenic carcinoma and to compare biochemical characteristics of their fluid with tuberculous pleural effusions. Methods: This study consisted of 119 patients diagnosed with malignant (54), tuberculous (65) pleural effusions. We examined the following biochemical parameters in the pleural fluid: adenosine deaminase, lactate dehydrogenase. Results: Malignant pleural effusions had a higher level of PLDH than tuberculous pleural effusions(P<0.001). Tuberculous effusions had significantly higher levels of PADA than those of malignant effusions (P<0.001). Of the 54 bronchogenic carcinoma cases, 52 (96.3%) were diagnosed correctly when PADA and PLDH were evaluated together. Conclusion: Our results show that high pleural LDH and low PADA levels are suggestive of pleural effusion due to bronchogenic carcinoma, whereas high levels of PADA alone can be indicative of tuberculous pleural effusion.