多指标联合检测鉴别渗出与漏出性胸腔积液的研究-呼吸内科专业论文.docxVIP

分别是81%和91%，AUC为0.913。(4) 四项指标检测如符合一项以上，敏感性和特 异性分别为98%和86%；如四项指标全部符合，敏感性和特异性分别为89%和98%。 结论 多指标联合检测对于渗、漏出性胸腔积液的鉴别诊断有一定的价值；和Light 标准比较，敏感性差别不大，但特异性高，可作为Light标准的补充。 【关键词】 渗出液 漏出液 胸腔积液 多指标 鉴别诊断 The study on multiple-index joint inspection in the diagnosis of the exudative and the transudatory pleural effusion Abstract Objective ：To investigate pleural effusion cholesterol(PE CHOL), pleural effusion cholesterol and serum cholesterol ratio(P/S CHOL) ,pleural effusion C-reactive protein (PE CRP) and serum-effusion albumin gradient (SEAG); compared with Light standard：pleural effusion protein and serum protein ratio (P/S PRO)、pleural effusion lactate dehydrogenase and serum lactate dehydrogenase ratio(P/S LDH) and pleural effusion lactate dehydrogenase(PE LDH);to explore the value of the multiple-index joint inspection in the diagnosis of the exudative and the transudatory pleural effusion . Methods ：The 137 patients with different causes of pleural effusion (93 males,44 females ,average 52.1 years old) were divided into exudates group(71 males, 23 females, with a total of 94 patients and a mean of 50.1 years) and transudate group(22 males , 21 female with a total of 43 patients, and a mean of 54.8 years),diagnostic criteria is based on clinical symptom and related inspection. Various indexes related to pleural effusion can be inspected in parallel by using the OLYMPUS AU400 automatic biochemical analyzer. The receiver operator characteristic (ROC) curve can be obtained by analyzing the data of the statistics. Results ：(1) The levels of the exudative pleural effusion (including P/S PRO, P/S LDH, and PE LDH) are apparently higher than that of the transudatory pleural effusion with the results as 0.7±0.1、0.9±0.2、290.7±49.9 IU/L and 0.2±0.1、0.5±0.1、161.1±46.3 IU/L ,respectively. The difference was statistics significance (P0.05). According to the Light’s (P/S PRO0.5、P/S LDH0.6、PE LDH200 IU/L) ,respectively, the sensitivity and specificity of them were 99% and 81%.(2)The level