临床肺科杂志
臨床肺科雜誌
림상폐과잡지
JOUNAL OF CLINICAL PULMONARY MEDICINE
2014年
11期
2046-2049
,共4页
黄海%彭孝红%甘辉%张炎林
黃海%彭孝紅%甘輝%張炎林
황해%팽효홍%감휘%장염림
胸腔积液%腺苷脱氨酶%C反应蛋白%癌胚抗原%乳酸脱氢酶
胸腔積液%腺苷脫氨酶%C反應蛋白%癌胚抗原%乳痠脫氫酶
흉강적액%선감탈안매%C반응단백%암배항원%유산탈경매
pleural effusion%adenosine deaminase%C reactive protein%carcinoembryonic antigen%lactate dehydrogenase
目的：探讨联合检测胸腔积液中腺苷脱氨酶( ADA)、C反应蛋白( CRP)、癌胚抗原( CEA)、乳酸脱氢酶( LDH)对结核性和恶性胸腔积液的诊断价值。方法以我院2012年1月至2012年12月112例住院的胸腔积液患者为研究对象,其中62例结核性胸腔积液患者,50例恶性胸腔积液患者,以酶比色法,免疫比浊法,速率法和电化学发光法检测上述患者胸腔积液中ADA、CRP、CEA和LDH浓度。结果结核性胸腔积液患者ADA和CRP的诊断敏感性显著高于恶性胸腔积液患者(P<0．01),恶性胸腔积液患者CEA的诊断敏感性较结核性胸腔积液患者明显增高(P<0．01)。以胸腔积液CEA>7 ng/ml及LDH>245 U/L为诊断标准,诊断恶性胸腔积液的敏感性,特异性分别为78．0%,80．6%；而以CEA<7 ng/ml,LDH>245 U/L及ADA<40 U/L,CRP<5 mg/L为诊断标准,诊断恶性胸腔积液的敏感性,特异性分别为94．0%,95．2%。以胸腔积液ADA>40 U/L,CRP>5 mg/L为诊断标准,诊断结核性胸腔积液的敏感性,特异性分别为82．3%,86．0%；而以CEA<7 ng/ml,LDH>245 U/L及ADA>40U/L,CRP>5 mg/L为诊断标准,诊断结核性胸腔积液的敏感性,特异性分别为96．8%,92．0%。结论联合检测胸腔积液中ADA、CRP、CEA、LDH的浓度可提高结核性和恶性胸腔积液鉴别诊断的敏感性和特异性。
目的：探討聯閤檢測胸腔積液中腺苷脫氨酶( ADA)、C反應蛋白( CRP)、癌胚抗原( CEA)、乳痠脫氫酶( LDH)對結覈性和噁性胸腔積液的診斷價值。方法以我院2012年1月至2012年12月112例住院的胸腔積液患者為研究對象,其中62例結覈性胸腔積液患者,50例噁性胸腔積液患者,以酶比色法,免疫比濁法,速率法和電化學髮光法檢測上述患者胸腔積液中ADA、CRP、CEA和LDH濃度。結果結覈性胸腔積液患者ADA和CRP的診斷敏感性顯著高于噁性胸腔積液患者(P<0．01),噁性胸腔積液患者CEA的診斷敏感性較結覈性胸腔積液患者明顯增高(P<0．01)。以胸腔積液CEA>7 ng/ml及LDH>245 U/L為診斷標準,診斷噁性胸腔積液的敏感性,特異性分彆為78．0%,80．6%；而以CEA<7 ng/ml,LDH>245 U/L及ADA<40 U/L,CRP<5 mg/L為診斷標準,診斷噁性胸腔積液的敏感性,特異性分彆為94．0%,95．2%。以胸腔積液ADA>40 U/L,CRP>5 mg/L為診斷標準,診斷結覈性胸腔積液的敏感性,特異性分彆為82．3%,86．0%；而以CEA<7 ng/ml,LDH>245 U/L及ADA>40U/L,CRP>5 mg/L為診斷標準,診斷結覈性胸腔積液的敏感性,特異性分彆為96．8%,92．0%。結論聯閤檢測胸腔積液中ADA、CRP、CEA、LDH的濃度可提高結覈性和噁性胸腔積液鑒彆診斷的敏感性和特異性。
목적：탐토연합검측흉강적액중선감탈안매( ADA)、C반응단백( CRP)、암배항원( CEA)、유산탈경매( LDH)대결핵성화악성흉강적액적진단개치。방법이아원2012년1월지2012년12월112례주원적흉강적액환자위연구대상,기중62례결핵성흉강적액환자,50례악성흉강적액환자,이매비색법,면역비탁법,속솔법화전화학발광법검측상술환자흉강적액중ADA、CRP、CEA화LDH농도。결과결핵성흉강적액환자ADA화CRP적진단민감성현저고우악성흉강적액환자(P<0．01),악성흉강적액환자CEA적진단민감성교결핵성흉강적액환자명현증고(P<0．01)。이흉강적액CEA>7 ng/ml급LDH>245 U/L위진단표준,진단악성흉강적액적민감성,특이성분별위78．0%,80．6%；이이CEA<7 ng/ml,LDH>245 U/L급ADA<40 U/L,CRP<5 mg/L위진단표준,진단악성흉강적액적민감성,특이성분별위94．0%,95．2%。이흉강적액ADA>40 U/L,CRP>5 mg/L위진단표준,진단결핵성흉강적액적민감성,특이성분별위82．3%,86．0%；이이CEA<7 ng/ml,LDH>245 U/L급ADA>40U/L,CRP>5 mg/L위진단표준,진단결핵성흉강적액적민감성,특이성분별위96．8%,92．0%。결론연합검측흉강적액중ADA、CRP、CEA、LDH적농도가제고결핵성화악성흉강적액감별진단적민감성화특이성。
Objective To investigate the clinical significance of combined detection of adenosine deaminase ( ADA) , C reactive protein ( CRP) , carcinoembryonic antigen ( CEA) and lactate dehydrogenase ( LDH) in pleural fluid in the differential diagnosis of tuberculous pleural effusion ( TPE ) and malignant pleural effusion ( MPE ) . Methods 112 patients with pleural effusion were selected, including 62 patients with tuberculous pleural effusion and 50 patients with malignant pleural effusion. The expressions of ADA, CRP, CEA and LDH were detected in the two groups by enzyme colorimetry, immune turbidimetry, rate method and electrochemiluminescence. Results The diagnosis sensitivity of ADA and CRP was significantly higher in patients with TPE than patients with MPE ( P <0. 01), and the diagnosis sensitivity of CEA was significantly higher in patients with MPE than in patients with TPE (P<0. 01). Taking CEA>7ng/ml and LDH>245U/L in pleural effusion as standard, the diagnosis sensitivity of MPE was 78% and the specificity was 80. 6%. While taking CEA<7ng/ml, LDH>245U/L, ADA<40U/L and CRP<5mg/L as standard, the sensitivity of MPE increased to 94. 0% and the specificity 80. 6%. Taking ADA<40U/L and CRP<5mg/L as standard, the diagnosis sensitivity of TPE was 82. 3% and the specificity was 86. 0%, and it increased to 96. 8% and 92. 0% respectively while taking CEA<7ng/ml, LDH>245U/L, ADA>40U/L and CRP>5mg as standard. Conclusion The combined detection of ADA, CRP, CEA and LDH can significantly im-prove the sensitivity and specificity in the differential diagnosis of tuberculous and malignant pleural effusion.
