胸腹水中C反应蛋白等免疫化学指标测定的临床意义

Combined detection of immunobiological markers in pleural or peritoneal exudates of patients with tuberculosis and malignant tumors

用生化法或电化学发光法测定48例结核性与82例恶性肿瘤患者胸腹水中C反应蛋白等免疫化学指标.结核性胸腹水中C反应蛋白、腺苷脱氨酶、β2-微球蛋白的水平,较恶性组明显升高（均P〈0.01）;而恶性组胸腹水中总胆固醇、乳酸脱氢酶、癌胚抗原、铁蛋白、糖链抗原153、细胞角蛋白19成分、神经元特异性烯醇化酶、甲胎蛋白、糖链抗原125、糖链抗原199的水平,较结核组明显升高（均P〈0.01）.联合检测C反应蛋白等多个免疫化学指标有利于诊断或鉴别诊断结核性和癌性胸腹水.

The levels of C-reactive protein（CRP）,adenosine deaminase（ADA）,total cholesterol （TC）,lactate dehydrogenase（LDH）,carcinoembryonic antigen（CEA）,ferritin（Fer）,β2-microglobulin （β2-MG）,alpha-fetoprotdn（AFP）,carbohydrate anfigen12-5（CA125）,carbohydrate antigen19-9（CAl99）,carbohydrate antigen15-3（CA153）,eyfra211（CY211）and neuron specific enolase（NSE）were detected by automatic chemistry analyzer or electrogenerated chemiluminescence analyzer in pleural and peritoneal exudates from 48 cases oftuberculosis and 82 cases of malignant tumors.The levels of CRP,ADA and β2-MG in tuberculotic exudates were higher than those in malignant exudates（P〈0.01）.However,the levels of TC,LDH,CEA,Fer,CA153,CY211,NSE,AFP,CA125 and CA199 in malignant exudates were higher than those in tuberculotic exudates（P〈0.01）.Combined determination of CRP,ADA,TC,LDH,CEA,Fer,and β2-MG in pleural and peritoneal exudates are of value in differentiation of tuberculosis from malignant exudates.Combined determination of CA153.CY211 and NSE in pleural effusions and AFP,CA125 and CA199 in peritoneal effusions can improve the semitivity and specificity of diagnosis for malignant exudates.