检测恶性胸腔积液患者胸腔积液和血清胰岛素、C肽、葡萄糖的意义

目的探讨恶性胸腔积液患者胸腔积液和血清胰岛素（insulin,Ins）、C肽（c-peptide,CP）、葡萄糖（glucose,Glu）检测的临床意义。方法分别采用放射免疫法（RIA）和己糖激酶法,测定45例恶性胸腔积液、31例结核性胸膜炎胸腔积液和血清Ins、CP、Glu水平,并设健康对照组。结果恶性胸腔积液、结核性胸膜炎组血清Ins浓度均明显低于对照组（P〈0.001）,恶性胸腔积液组胸腔积液Ins、CP、Glu浓度都显著高于血清Ins、CP、Glu水平（P〈0.05）,胸腔积液Ins/血清Ins比值恶性胸腔积液组显著大于结核性胸膜炎组（P〈0.05）。结论检测恶性胸腔积液患者胸腔积液和血清Ins、CP、Glu值可作为临床辅助鉴别诊断方法。

Detection of Ins, CP and Glu in the Pleural Effusion and Serum from Patients with Malignant Pleural Metastases

Objective To study the significance of analysis of the Ins,CP and Glu in the pleural effusion and serum from patients with malignant pleural metastases.Methods Levels of Ins,CP and Glu in the plerual effusion and serum were determined using RIA and hexokinase from 45 patients with malignant pleural metastases and 31 patients with tuberculous pleuritis.The levels of healthy controls were also analyzed.Results The Ins levels in the serum from patients with malignant pleural metastases and tuberculous pleuritis were significantly lower than that from healthy controls(P<0.001).The Ins,CP and Glu levels in the plerual effusion from patients with malignant pleural metastases were significantly higher than those in the serum(P<0.05).The Ins levels in the pleural effusion/serum from patients with malignant pleural metastases were significantly higher than those from patients with tuberculous pleuritis(P<0.05).Conclusion Detection of Ins,CP and Glu levels in the pleural effusion and serum may be helpful to the diagnosis of malignant pleural metastases.