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胸腔积液患者血液检测中标志物的特征及其与不同病因的相关性

Characterization of Markers in Blood Tests of Patients With Pleural Effusion and Their Correlation to Different Etiologies.

作者信息

Farah Raymond, Sidar-Orlin Keren, Sharabi-Nov Adi

机构信息

Department of Internal Medicine B, Ziv Medical Center, Safed, Israel.

Bar-Ilan University, The Azrieli Faculty of Medicine, Safed, Israel.

出版信息

J Community Hosp Intern Med Perspect. 2024 Sep 9;14(5):30-34. doi: 10.55729/2000-9666.1395. eCollection 2024.

Abstract

BACKGROUND

To investigate the etiology of pleural effusion, a variety of examinations are performed, including invasive ones: Thoracentesis is an invasive procedure to remove fluid or air from the pleural cavity for diagnostic or therapeutic purposes. Until now, there are no blood markers that can help us diagnose the type of pleural effusion without the need for pleural puncture or drainage.

AIMS

The aim of this study was to investigate the relationship and the utility of the new inflammatory markers taken from complete blood count (CBC) to differentiate between the various types of pleural effusion before the invasive procedure decision.

MATERIAL AND METHODS

This is an observational retrospective study. Data was collected from medical records of patients aged 18-90 admitted in Ziv Medical Center, Safed, Israel that were diagnosed with pleural effusion from 2013 to 2019. Of those patients, of whom inflammatory markers from blood counts and thoracentesis results were obtained, the outcomes were compared with the diagnosis type of pleural effusion.

RESULTS

This study involved 391 patients, 256 suffered from exudate type effusion, their median age was 72 years, while 135 suffered from transudate effusion, their median age was 80 years. Those with exudate effusion had higher levels of CRP, platelets, neutrophils, and lymphocytes in blood, whereas those with transudate effusion had higher levels of MPV and RDW in blood. Other blood markers such as NLR and PLR were not statistically significant, but were also higher in the blood of patients with exudate effusion.

CONCLUSION

An evaluation of simple and inexpensive measurements of blood count such as platelets, neutrophils, lymphocytes, MPV, RDW may provide insight into the etiology of pleural effusion.

摘要

背景

为了探究胸腔积液的病因,人们进行了多种检查,包括侵入性检查:胸腔穿刺术是一种侵入性操作,用于从胸腔中抽取液体或气体以达到诊断或治疗目的。到目前为止,尚无血液标志物能够帮助我们在无需胸腔穿刺或引流的情况下诊断胸腔积液的类型。

目的

本研究的目的是在决定是否进行侵入性操作之前,探究从全血细胞计数(CBC)中获取的新炎症标志物之间的关系及其在区分不同类型胸腔积液方面的效用。

材料与方法

这是一项观察性回顾性研究。数据收集自2013年至2019年在以色列萨费德的齐夫医疗中心收治的18至90岁被诊断为胸腔积液的患者的病历。在那些获得了血细胞计数炎症标志物和胸腔穿刺结果的患者中,将结果与胸腔积液的诊断类型进行了比较。

结果

本研究涉及391名患者,其中256名患有渗出液型积液,他们的中位年龄为72岁,而135名患有漏出液型积液,他们的中位年龄为80岁。渗出液型积液患者血液中的CRP、血小板、中性粒细胞和淋巴细胞水平较高,而漏出液型积液患者血液中的MPV和RDW水平较高。其他血液标志物如NLR和PLR无统计学意义,但在渗出液型积液患者血液中也较高。

结论

对血小板、中性粒细胞、淋巴细胞、MPV、RDW等简单且廉价的血细胞计数测量进行评估,可能有助于深入了解胸腔积液的病因。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/930a/11466329/b9fb49fa1236/jchim-14-05-030f1.jpg

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