85例血性心包积液的病因及诊断方法分析

The etiopathogenisis and diagnostic method of 85 cases with pericardial hemorrahagic effusion

目的:总结分析血性心包积液的病因及其诊断方法,为诊断和鉴别诊断提供指导性资料。方法:对85例血性心包积液患者的临床表现、影像学检查、实验室检查结果进行回顾分析。结果:85例血性心包积液的病因中,肿瘤性41例(48.23%)、结核性27例(31.76%)、其他各种原因引起者17例(20.01%)。肿瘤性心包积液中癌胚抗原的平均值173μg/L,显著高于结核性心包积液的平均值0.62μg/L;结核性心包积液腺苷脱氢酶平均值44.5U/L,显著高于癌性心包积液平均值15U/L;结核性心包积液患者中心包积液和血液抗结核抗体(kjhkt)检测阳性率分别为62.5%和75%,显著高于肿瘤性心包积液患者(均为阴性)。结论:恶性肿瘤和结核是血性心包积液的主要病因。心包积液的脱落细胞学检查和腺苷脱氢酶、癌胚抗原、kjhkt等项实验室检查为血性心包积液病因诊断和鉴别诊断的主要手段,联合应用可提高诊断的准确性。

Objective:The Summary analyses of the cause and diagnostic of pericardial hemorrahagic effusion in aim to provide the information of diagnos antidiastole.Method:Clinical manifestation and laboratory examination of 85 cases of pericardial hemorrahagic effusion were retrospectively analyzed.Result:The etiopathogenisis of pericardial hemorrahagic effusion in turn included tumor(41 cases),tuberculosis(27 cases)and other causes(17 cases).whose percentage were 48.23%,31.76%,20.01%;The level of CEA in patients with cancer(173 μg/L)were significantly higher than in patients with tuberculous(0.62 μg/L).The level of ADA in patients with tuberculous(44.5 U/L)were signidicantly higher than in patients with cance r(15 U/L).The positive rate of the TB anti-body in the pericardial effusion and blood of TB patients(62.5% and 75.0%)is higer significantly than that in cancer(negative of all).Conclusion:Cancer and tuberculous are the leading cause of pericardial hemorrahagic effusion.The Cell cast-off,CEA,ADA,TB anti-body of pericardial effusion is major diagnosis method.Allied application can raise precise degree of diagnositic.