Wolthuis A, Landewé R B, Theunissen P H, Westerhuis L W
Dept of Clinical Chemistry, Het Atrium Medisch Centrum, Heerlen, The Netherlands.
Eur Respir J. 1998 Nov;12(5):1233-5. doi: 10.1183/09031936.98.12051233.
The diagnosis chylothorax is based on a chemical analysis of the pleural effusion. According to the literature, this analysis can be rather straightforward, comprising measurements of triglycerides, chylomicrons, and cholesterol. In this report we present an autopsy case that alerted us to interpret these results critically. Although the laboratory tests of the pleural effusion in this patient with parenteral nutrition suggested chylothorax, additional tests (potassium (11.3 mmol.L(-1)) and glucose (128 mmol.L(-1)) proved otherwise. Comparison of the pleural effusion analysis and the content of the parenteral nutrition led to the final conclusion that the effusion was due to a leakage of parenteral nutrition instead of chylothorax. We therefore suggest adding glucose and potassium measurements to the biochemical work-up of a patient under suspicion of chylothorax.
乳糜胸的诊断基于胸腔积液的化学分析。根据文献，这种分析可能相当直接，包括甘油三酯、乳糜微粒和胆固醇的测量。在本报告中，我们展示了一例尸检病例，该病例提醒我们要审慎解读这些结果。尽管该接受肠外营养患者的胸腔积液实验室检查提示为乳糜胸，但进一步检查（钾离子（11.3 mmol.L⁻¹）和葡萄糖（128 mmol.L⁻¹））结果却并非如此。胸腔积液分析结果与肠外营养成分的比较得出最终结论，即该积液是由于肠外营养渗漏而非乳糜胸所致。因此，我们建议在对疑似乳糜胸患者进行生化检查时增加葡萄糖和钾离子的测量。
