生化参数对于胸腔积液鉴别诊断的意义

目的研究不同类型胸腔积液中各项生化参数的诊断价值。方法收集65例恶性胸腔积液患者,32例结核性胸腔积液患者和35例炎性胸腔积液患者的血液和胸腔积液标本。采用日立7150型生化自动分析仪测定腺苷脱氨酶(ADA)、乳酸脱氢酶(LDH)、总蛋白、白蛋白和葡萄糖的水平,进行统计学分析。结果结核组胸腔积液ADA水平高于恶性和炎性组(P<0.01);恶性组胸腔积液和血清中LDH水平高于结核组和炎性组(P<0.05);本组肺癌患者胸腔积液和血清LDH水平高于间皮瘤患者(P<0.05),间皮瘤患者胸腔积液中ADA水平高于肺癌患者(P<0.05)。结论胸腔积液高LDH水平和低ADA水平是恶性胸腔积液的特征;高ADA水平是结核性胸腔积液鉴别诊断的标志。

The value of biochemical parameters in diagnosis of pleural effusion

Objective To study the value of biochemical parameters in three types of pleural effusion.Methods Sixty-five cases of malignant pleural effusion,32 cases of tuberculous pleural effusion and 35 cases of pneumonic pleural effusion were included in this study.Measure the level of adenosine deaminase(ADA),lactate dehydrogenase(LDH),protein,albumin and glucose with HITACHI 7150 analyzer,and analyze the differences statistically.Results The activities of ADA in tuberculous group were higher than those in the malignant and pneumonic pleural effusion group(P<0.01).LDH activities in malignant pleural effusion and serum were higher than those in the other groups(P<0.05).LDH activities in bronchogenic carcinoma were higher than those in mesothelioma group(P<0.05).ADA activities in mesothelioma pleural effusin were higher than those in bronchogenic carcinoma group(P<0.05).Conclusion High LDH level and low ADA level in pleural effusion are the indicators of malignant pleural effusion,and high ADA level is the diagnostis marker of tuberculous pleural effusion.