Chetty K G
Clin Chest Med. 1985 Mar;6(1):49-54.
A transudative pleural effusion develops when the systemic factors influencing the formation or absorption of the pleural fluid are altered. The pleural surfaces are not involved by the primary pathologic process. The diagnosis of transudative effusion is simple to establish by examining the characteristics of the pleural fluid. Transudates have all of the following three characteristics: The ratio of the pleural fluid to the serum protein is less than 0.5. The ratio of the pleural fluid to the serum LDH is less than 0.6. The pleural fluid LDH is less than two thirds the upper limit of normal for the serum LDH. Among the conditions that produce transudative pleural effusion, congestive heart failure is by far the most common. Pulmonary embolism, cirrhosis of the liver with ascites, and the nephrotic syndrome are the other common causes. Management of transudative pleural effusions involves managing the primary disease. Refractory, massive effusions can be controlled by tetracycline pleurodesis.
当影响胸腔积液形成或吸收的全身因素发生改变时，就会出现漏出性胸腔积液。原发性病理过程不累及胸膜表面。通过检查胸腔积液的特征，漏出性胸腔积液的诊断很容易确立。漏出液具有以下三个特征：胸腔积液与血清蛋白的比值小于0.5；胸腔积液与血清乳酸脱氢酶（LDH）的比值小于0.6；胸腔积液LDH小于血清LDH正常上限的三分之二。在导致漏出性胸腔积液的疾病中，充血性心力衰竭是迄今为止最常见的。肺栓塞、伴有腹水的肝硬化和肾病综合征是其他常见原因。漏出性胸腔积液的治疗包括治疗原发性疾病。难治性大量胸腔积液可用四环素胸膜固定术控制。
