多项指标检测在胸腔积液诊断中的价值

目的 探讨胸腔积液患者胸液中ADA、LDH、GLU、TBAb、CA242、CEA和SA七项指标对胸腔积液性质鉴别诊断的实用价值。方法将不同病因的胸腔积液患者145例分为结核性渗出液组65例、恶性渗出液组55例和化脓渗出液组25例。平行检测患者胸液中七项指标水平。结果 结核性胸液组ADA值(114±23.6u／l)和TBAb阳性率为95.4％明显高于癌性(ADA57 12.6u／l)和化脓性胸液组(ADA61 11.9U／l)(均P<0.01)。化脓性胸液组LDH(1069±39.7u／l)水平明显高于癌性(594 34.6u／l)和结核性(638 31.9u／l)胸液组,而GLU(3.01±0.56mmol／l)水平明显低于恶性(6.13 0.91mmol／l)和结核性(5.45 0.86mmol／l)胸液组(均P<0.01)。恶性胸液组CA242(63.7 11.4ku／l)和CEA(71.6 15.6ug/l)水平明显高于结核性(20.1 4.5ku／l 17.6 5.7ug／l)和化脓性(16.9 3.8ku／l 14.2 5.lug／l)渗出液组(均P<0.01)。结论ADA和TBAb联合检测对鉴别诊断结核性胸液有较高的实用价值,LDH和GLU联合检测对鉴别诊断化脓性胸液有较大价值,CA242和CEA联合检测对鉴别诊断有很大实用价值。

The differential diagnosis value of many indices in pleural effusion

Objective To determine the differential diagnosis vaiue of the levels of ADA,LDH, GLU,TBAb,CA242,CEA and SA in pleural effusion in patients with pleural effusion. Methods 145 cases with differential diagnostic pleural effusion were divided into tuberculous exudative 65 cases,mdlignant exudative 55 cases and maturation exudative groups 25 cases. Value of seven indices were simultaneously determined in three groups. Results The level of ADA( 114 23.6u/l) or TBAb(95.4%) in tuberculous exudative group was significantly higher than malignant exudative( ADA57 12. 6u/l) and maturation exudative( ADA61 11.9u/l) groups( all p < 0.01) . The level of LDH in maturation exuda tive( 1069 39.7u/l) group was significantly higher tham malignant exudative(594 34.6u/l) and tuberculous exudative(638 31.9u/l) groups(p< 0.01) , But the level of GLU in maturation exudative(3.01 0.56mmol/l) was significantly lower than mdlignant exudative(6.13 0.91mmol/l) and tuberculous exudative(5.45 0.86mmol/l) groups(p<0.01) .The level of CA242 or CEA in malignant exudative(63.7 11.4ku/l 71.6 15.6ug/l) group was significantly higher than tuberculous(20.1 4. 5ku/l 17.6 5.7ug/l) and maturation exudative (16.9 3.8ku/l 14.2 5.1 ug/1) groups( all p < 0.01) . Conclusion There are diagnostie values in ADA and TBAb for identifying the property of tuberculous exudative, There are diagnostic values in LDH and GLU for identifying the property of maturation exudative, There are diagnostic vaiues in CA242 and CEA for identifying the property of malignant exudative.