电子支气管镜检查及多次测定胸水CEA、ADA对老年性胸腔积液的诊断价值探讨

Diagnostic Significance of Electronic Bronchoscope and CEA, ADA Examination on Pleural Fluid in Old Patients

目的:探讨电子支气管镜联合胸水CEA、ADA检查对老年胸腔积液的诊断价值。方法:1 999年6月至2 0 0 4年1 0月间住院不明病因的6 8例老年胸腔积液的患者,予以电子支气管镜检查及毛刷活检、术后痰检找抗酸杆菌等检查,并测定胸水CEA、ADA。结果:电子支气管镜对恶性胸腔积液诊断率达76 .3%,对结核性胸腔积液诊断率为2 2 .7%;恶性胸腔积液的胸水CEA显著高于非恶性胸腔积液,结核性胸水ADA明显高于恶性胸水及其它胸水组。结论:电子支气管镜检查结合胸水CEA、ADA多次测定对老年性胸腔积液有较高诊断价值,值得临床推广应用。

Objective: To investigate the diagnostic value of electronic bronchoscope and CEA, ADA assay in pleural fluid in the old patients. Methods: 68 old patients suffering from pleural fluid, which unknown causes, in our hospital from Jun.1999 to Oct.2004 were examined by the electronic bronchoscope, brush biopsy, and the level of the CEA and ADA in pleural fluid and sputum were examination. Results: 76.3% and 22.7% patients were diagnosed to have the malignant and tuberculosis pleural fluid respectively by electronic bronchoscope. The level of CEA in malignant pleural fluid is obviously higher than that in benign pleural fluid; the level of the ADA in tuberculosis pleural fluid is evidently higher than that in other kinds of pleural fluid. Conclusions: There is higher diagnostic value to different the feature of pleural fluid in the old patients with unknown pathogenic pleural fluid by the electronic bronchoscope and repeat assaying CEA、ADA in pleural fluid.