胸腔积液胆固醇在鉴别漏出性胸腔积液与渗出性胸腔积液中的作用。

Role of pleural fluid cholesterol in differentiating transudative from exudative pleural effusion.

作者信息

Guleria R, Agarwal S R, Sinha Sanjeev, Pande J N, Misra Anoop

机构信息

Department of Medicine, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India.

出版信息

Natl Med J India. 2003 Mar-Apr;16(2):64-9.

PMID:12816183

Abstract

BACKGROUND

Pleural fluid cholesterol has been reported to be useful in distinguishing between transudative and exudative pleural effusion. However, the difference in lipid profile between tubercular and non-tubercular pleural effusion has not been studied.

METHODS

The lipid profile of pleural fluid in 50 patients with exudative (25 tubercular and 25 non-tubercular) and 25 with transudative effusion was studied. The diagnosis was based on clinical criteria and/or a positive diagnosis from another site.

RESULTS

The criteria that best identified an exudative pleural effusion were pleural fluid cholesterol > or = 60 mg/dl, pleural fluid to serum cholesterol ratio > or = 0.4, pleural fluid triglyceride > or = 40 mg/dl and pleural fluid to serum triglyceride ratio > or = 0.3. Pleural fluid cholesterol had a sensitivity of 88% and a specificity of 100% for exudates with an accuracy of 92%. Pleural fluid to serum cholesterol ratio had a sensitivity of 98% and a specificity of 84%. These results were superior to the criteria proposed by Light et al. (sensitivity 98% and specificity 80%).

CONCLUSION

Pleural fluid cholesterol estimation is an effective and cost-efficient method of differentiating exudative from transudative pleural effusion. The lipid profile does not help in diagnosing tubercular effusion.

摘要

背景

据报道，胸腔积液胆固醇有助于区分漏出液和渗出液。然而，结核性和非结核性胸腔积液的脂质谱差异尚未得到研究。

方法

研究了50例渗出性胸腔积液患者（25例结核性和25例非结核性）和25例漏出性胸腔积液患者的胸腔积液脂质谱。诊断基于临床标准和/或其他部位的阳性诊断。

结果

最能鉴别渗出性胸腔积液的标准为胸腔积液胆固醇≥60mg/dl、胸腔积液与血清胆固醇比值≥0.4、胸腔积液甘油三酯≥40mg/dl以及胸腔积液与血清甘油三酯比值≥0.3。胸腔积液胆固醇对渗出液的敏感性为88%，特异性为100%，准确性为92%。胸腔积液与血清胆固醇比值的敏感性为98%，特异性为84%。这些结果优于Light等人提出的标准（敏感性98%，特异性80%）。