现代医药卫生
現代醫藥衛生
현대의약위생
MODERN MEDICINE HEALTH
2014年
15期
2246-2247
,共2页
结核,胸膜/血液%结核,胸膜/诊断%胸腔积液,恶性/血液%诊断,鉴别%腺苷脱氨酶%癌胚抗原%乳酸脱氢酶类
結覈,胸膜/血液%結覈,胸膜/診斷%胸腔積液,噁性/血液%診斷,鑒彆%腺苷脫氨酶%癌胚抗原%乳痠脫氫酶類
결핵,흉막/혈액%결핵,흉막/진단%흉강적액,악성/혈액%진단,감별%선감탈안매%암배항원%유산탈경매류
Tuberculosis,pleura/blood%Tuberculosis,pleura/diagnosis%Pleural effusion,malignant/blood%Diag-nosis,differential%Adenosine deaminase%Carcinoembryonic antigen%Lactate dehydrogenases
目的：检测结核性与肿瘤性胸腔积液中腺苷脱氨酶（ADA）、癌胚抗原（CEA）、糖链抗原125（CA125）、乳酸脱氢酶（LDH）水平，探讨其在鉴别诊断中的价值。方法选择2010年1月至2013年6月在该院住院的不明原因渗出性胸腔积液（胸腔积液生化、血常规、脱落细胞、细菌学、B超、肺CT等检查仍未确诊者）患者，经内科胸腔镜检查，确诊结核性胸腔积液组88例和肿瘤性胸腔积液组70例。术中同时抽取胸腔积液标本检测其ADA、CEA、CA125、LDH水平，进行统计学分析。结果结核性胸腔积液ADA水平显著高于肿瘤性胸腔积液，差异有统计学意义（t=21.490，P＜0.01）；肿瘤性胸腔积液CEA、CA125水平均显著高于结核性胸腔积液，差异均有统计学意义（t=41.300、18.400，P＜0.01）；结核性和肿瘤性胸腔积液LDH水平比较，差异无统计学意义（t=1.562，P＞0.05）。结论 ADA水平越高，结核可能性越大；CEA、CA125水平越高，肿瘤的可能性也更大；CEA、CA125水平均同时增高，肺癌可能性更大；LDH水平在结核与肿瘤性胸腔积液中差异不明显，所以联合检测ADA、CEA、CA125、LDH水平对胸腔积液性质的鉴别诊断具有重要的参考价值。
目的：檢測結覈性與腫瘤性胸腔積液中腺苷脫氨酶（ADA）、癌胚抗原（CEA）、糖鏈抗原125（CA125）、乳痠脫氫酶（LDH）水平，探討其在鑒彆診斷中的價值。方法選擇2010年1月至2013年6月在該院住院的不明原因滲齣性胸腔積液（胸腔積液生化、血常規、脫落細胞、細菌學、B超、肺CT等檢查仍未確診者）患者，經內科胸腔鏡檢查，確診結覈性胸腔積液組88例和腫瘤性胸腔積液組70例。術中同時抽取胸腔積液標本檢測其ADA、CEA、CA125、LDH水平，進行統計學分析。結果結覈性胸腔積液ADA水平顯著高于腫瘤性胸腔積液，差異有統計學意義（t=21.490，P＜0.01）；腫瘤性胸腔積液CEA、CA125水平均顯著高于結覈性胸腔積液，差異均有統計學意義（t=41.300、18.400，P＜0.01）；結覈性和腫瘤性胸腔積液LDH水平比較，差異無統計學意義（t=1.562，P＞0.05）。結論 ADA水平越高，結覈可能性越大；CEA、CA125水平越高，腫瘤的可能性也更大；CEA、CA125水平均同時增高，肺癌可能性更大；LDH水平在結覈與腫瘤性胸腔積液中差異不明顯，所以聯閤檢測ADA、CEA、CA125、LDH水平對胸腔積液性質的鑒彆診斷具有重要的參攷價值。
목적：검측결핵성여종류성흉강적액중선감탈안매（ADA）、암배항원（CEA）、당련항원125（CA125）、유산탈경매（LDH）수평，탐토기재감별진단중적개치。방법선택2010년1월지2013년6월재해원주원적불명원인삼출성흉강적액（흉강적액생화、혈상규、탈락세포、세균학、B초、폐CT등검사잉미학진자）환자，경내과흉강경검사，학진결핵성흉강적액조88례화종류성흉강적액조70례。술중동시추취흉강적액표본검측기ADA、CEA、CA125、LDH수평，진행통계학분석。결과결핵성흉강적액ADA수평현저고우종류성흉강적액，차이유통계학의의（t=21.490，P＜0.01）；종류성흉강적액CEA、CA125수평균현저고우결핵성흉강적액，차이균유통계학의의（t=41.300、18.400，P＜0.01）；결핵성화종류성흉강적액LDH수평비교，차이무통계학의의（t=1.562，P＞0.05）。결론 ADA수평월고，결핵가능성월대；CEA、CA125수평월고，종류적가능성야경대；CEA、CA125수평균동시증고，폐암가능성경대；LDH수평재결핵여종류성흉강적액중차이불명현，소이연합검측ADA、CEA、CA125、LDH수평대흉강적액성질적감별진단구유중요적삼고개치。
Objective To detect the levels of adenosine deaminase(ADA),carcino-embryonic antigen(CEA),carbohy-drate antigen(CA) 125 and lactic dehydrogenase(LDH) in tuberculous and malignant pleural effusions,and explore their value in diagnosis and differentiation. Methods A total of 158 patients with unexplained exudative pleural effusions ,who were exam-ined by biochemical tests of pleural effusion,blood routine,cast-off cells,pacteriology,type B ultrasound,lung CT and so on in the hospital from January 2010 to June 2013,were selected,and diagnosed with tuberculous pleural effusions(n=88) and malignant pleural effusions(n=70) by medical thoracoscopy. The pleural effusion was extracted during operation to determine the levels of A-DA,CEA,CA125 and LDH for statistical analysis. Results The ADA level of tuberculous pleural effusion was significantly high-er than that of malignant pleural effusions (t=21.490,P<0.01),The levels of CEA and CA125 of malignant pleural effusions were obviously higher than those of tuberculous pleural effusion with statistically significant difference (t=41.300,18.400;P<0.01). The difference on the LDH levels between tuberculous and malignant pleural effusions showed no significant difference (t=1.562, P>0.05). Conclusion The higher of the ADA level,the greater of the possibility of tuberculosis;the higher of the CEA and CA125 levels,the greater of the possibilities of tumor;when the CEA and CA125 are both increased,it is more likely to be lung can-cer;the difference of LDH level is not obvious in tuberculous and malignant pleural effusions,so the combined detection of ADA, CEA,CA125 and LDH has important clinical reference in differential diagnosis of the tuberculous and malignant pleural effusions.
