Pettersson T, Klockars M, Hellström P E
Thorax. 1982 May;37(5):354-61. doi: 10.1136/thx.37.5.354.
The value of determination of pleural fluid glucose, pH, lactic dehydrogenase, IgG, IgA, IgM, C3, C4, anti-IgG antibody, and hydroxyproline in distinguishing between pleural effusions caused by rheumatoid arthritis (RA) and those resulting from other diseases was studied. The series comprised seven patients with RA and 115 patients with other diseases including systemic lupus erythematosus, tuberculosis, malignant disease, empyema, pneumonia, congestive heart failure, and nonspecific pleural effusion. The low glucose concentration, the low pH and the low C4 level in rheumatoid pleural effusion were the most valuable diagnostic findings. The presence of anti-IgG antibody in pleural fluid was not specific for RA. The concentration of hydroxyproline in pleural fluid and the pleural fluid-to-plasma hydroxyproline ratio were significantly higher in RA than in tuberculosis and malignant disease. The results support the view that local metabolic and immunological phenomena as well as a high turnover of collagen occur in the pleural cavity in RA.
研究了测定胸腔积液葡萄糖、pH值、乳酸脱氢酶、IgG、IgA、IgM、C3、C4、抗IgG抗体和羟脯氨酸在区分类风湿关节炎（RA）所致胸腔积液与其他疾病所致胸腔积液中的价值。该系列包括7例RA患者和115例患有其他疾病的患者，这些疾病包括系统性红斑狼疮、结核病、恶性疾病、脓胸、肺炎、充血性心力衰竭和非特异性胸腔积液。类风湿胸腔积液中葡萄糖浓度低、pH值低和C4水平低是最有价值的诊断发现。胸腔积液中抗IgG抗体的存在对RA并不具有特异性。RA患者胸腔积液中羟脯氨酸的浓度以及胸腔积液与血浆羟脯氨酸的比值显著高于结核病和恶性疾病患者。结果支持这样一种观点，即RA患者胸腔内发生局部代谢和免疫现象以及胶原蛋白的高周转率。
