联合检测TP、ADA、CEA在胸腔积液性质鉴别诊断中的价值

目的探讨胸腔积液TP（总蛋白）、ADA（腺苷脱氨酶）、CEA（癌胚抗原）三个项目联合检测对胸腔积液性质鉴别诊断的价值。方法将153例由不同病因引起胸腔积液的患者分为三组，其中由肺结核、结核性胸膜炎引起的为结核组共78例，由肺癌、恶性肿瘤胸膜转移引起的为恶性组共43例，由心衰、重度营养不良引起的为漏出液组共32例，平行检测这三组胸腔积液中TP、ADA、CEA浓度。结果结核组ADA平均为（57．6±12．2）U／L，显著高于恶性组和漏出液组（P〈0．01）；恶性组CEA平均含量为（31．2±10．7）μg／L，显著高于结核组和漏出液组（P〈0．01）：漏出液组TP平均含量为（12．5±5．3）g／L，显著低于结核组和恶性组（P〈0．01）。结论联合检测胸腔积液中的11P、ADA、CEA，有助于临床医生对胸腔积液性质的鉴别、形成的原因及对相关部位疾病的诊断。

Value of joint detection of TP, ADA and CEA in differential dignosis of pleural effuision

Objective To discuss the differential diagnostic value of detection of TP,ADA and CEA in patients with hydrothorax. Methods There 153 patients with pleural effusion caused by different kinds of diseases were divided into three groups , tuberculous exudation group consisted of 78 cases due to pulmonary tuberculosis or tuberculous peritonitis, malignant exudation group consisted of 43 cases due to lung cancer or pleural metastasis in malignant tumor and transudate group conssited of 32 cases due to cardiac failure or gravis dystrophy. The levels of TP,ADA ,CEA were simultaneously detected in pleural effusion of the three groups. Results The level of ADA（57.6±12.2U/L） in tuberculous exudation group was significantly higher than malignant exudation group and transudate group （ P 〈 0.01 ） ; The level of CEA（ 31.2±10.7μg/L） in malignant exudation group was significantly higher than tuberculous exudation group and transudate group （P 〈 0.01 ） ; The level of TP （12.5±5.3g/L） in transudate group was significantly lower than tuberculous exudation group and malignant exudation group （ P 〈 0.01 ）. Conclusion Joint detection of the three indicators is helpful for differential pathogenic diagnosis lung cancer accompanied with pleural effusiion.