【作者】 胡望平； 李小健； 胡盈莹； 黄兢姚；

【Author】 HU Wang - Ping, HU Ying - Ying, Li Xiaojian(clinical chemistry department, Fuzhou general hospital ; Fuzhou 350025 , China. Institute of Hepatology, FuZhou Infectious Hospital, Fuzhou, 350025 , China. Fujian Medical University Union Hospital Department of Introduce Enter , 350001, China. )

【机构】 福州军区福州总医院生化科福建医大福总临床医学院； 福州市传染病医院肝病研究所； 福建医大协和医院；

【摘要】 目的探讨胸水胆固醇浓度(Pch)、胸水与血清胆固醇浓度(Sch)的比值(P/Sch)、胸水尿酸浓度(Pua)对胸腔积液渗漏性的鉴别诊断价值。方法对85例胸腔积液患者检测Pch和65例患者检测Pua,并计算出P/Sch,分别研究Pch、P/Sch、Pua、胸水总蛋白(Ptpr)对胸水渗漏性诊断的ROC、灵敏度、特异性与诊断效率。结果Pch、P/Sch、Pua、Ptpr对胸水渗出液诊断的灵敏度分别为96.2%、90.4%、79.5%和90.6%,特异性分别为100%、89.7%、61.9%和80.6%。胸水胆固醇鉴别渗出液和尿酸鉴别漏出液的ROC曲线下面积分别是0.986和0.655。从理论分析胸水胆固醇浓度鉴别渗出液特异性,与胸膜毛细血管壁通透性有关,决定于低密度脂蛋白的分子大小。结论Pch、P/Sch、Ptpr对胸水渗出液具有较高的鉴别诊断价值,ROC亦证明胸水胆固醇鉴别渗出液和尿酸监测漏出液是可行的,Pch的诊断效率最高(P<0.05)。Pua对胸水监测漏出液有一定价值。尿酸增加表示机体抗氧化状态佳,提示预后较好。更多还原

【Abstract】 Objective: To investigate the value of pleural fluid cholesterol (Pch) , pleural fluid uric acid (Pua) to distinguish transudates from exudates. Method: Case 85 patients pleural fluid cholesterol levels were measured. The ROC, sensitivity, specifity and diagnostic efficiency of Pch, Pua were studied and compared with the pleural fluid total protein (Ptpr) criteria of traditional method. Result: The semsitivity of Pch, P/Sch, Ptpr, Pua to distinguish transudates from exudates were 96. 2% , 90. 4% , 90. 6% and 79.5%. The specifity were 100% , 89. 7% , 80. 6% and 61. 9%. The Area under the curve test result of ROC are respectively 0. 986 and 0. 655, on Pch to distinguish exudates from transudates and Pua to distinguish transudates from exudates . Conclusion: Pch, P/Sch and Ptpr may be to differentiate exudates , It is demonstrated as will by ROC that Cholesterol to differentiate exudates and Uric Acid to Distinguish Transudates in Pleural Fluid is possible . Pch had a highest diagnostic efficiency (P < 0. 05). pleural fluid uric acid may be to distinguish transudates, Pua increase may be found in conditions associated with antioxidant response , may be prompt a good prognosis.更多还原