Kalayci A G, Gürses N, Adam B, Albayrak D
Department of Pediatrics, Ondokuz Mayis University, School of Medicine, Samsun, Turkey.
Clin Pediatr (Phila). 1996 Jul;35(7):353-8. doi: 10.1177/000992289603500704.
We studied 60 children, ages 3-15 years, with pleural effusions to determine the usefulness of different criteria for the separation of transudates from exudates. Twenty of these effusions were classified as transudates and 40 as exudates. Pleural cholesterol (P chol), pleural/serum cholesterol ratio (P/S chol), and pleural/serum beta 2 microglobulin (P/S beta 2 m) were determined to characterize pleural effusions and were compared with Light's criteria (pleural/serum protein ratio, pleural LDH, pleural/serum LDH ratio). With a threshold of 0.3, the sensitivity and specificity of P/S chol for diagnosis of exudates were 95 and 90%, respectively. With a threshold of 1.3, the sensitivity of P/S beta 2 m was 77.5%, and its specificity was 95%. Our findings indicate that determination of P chol and P/S chol, as well as Light's criteria, is of value for characterizing pleural effusions in childhood, but the measurement of P/S beta 2 m is less sensitive in distinguishing transudates from exudates and it should not be used routinely.
我们研究了60名年龄在3至15岁之间有胸腔积液的儿童，以确定不同标准区分漏出液和渗出液的有用性。这些积液中20例被分类为漏出液，40例为渗出液。测定胸腔胆固醇（P chol）、胸腔/血清胆固醇比值（P/S chol）和胸腔/血清β2微球蛋白（P/S beta 2 m）以表征胸腔积液，并与Light标准（胸腔/血清蛋白比值、胸腔乳酸脱氢酶、胸腔/血清乳酸脱氢酶比值）进行比较。P/S chol诊断渗出液的阈值为0.3时，其敏感性和特异性分别为95%和90%。P/S beta 2 m阈值为1.3时，其敏感性为77.5%，特异性为95%。我们的研究结果表明，测定P chol和P/S chol以及Light标准对于儿童胸腔积液的表征有价值，但P/S beta 2 m在区分漏出液和渗出液方面敏感性较低，不应常规使用。
