联合检测降钙素原与癌胚抗原在胸腔积液中的诊断价值

Diagnostic value of combined detection procalcitonin and carcinoembryonic antigen in pleural effusion

目的探讨联合检测胸腔积液降钙素原（PCT）与癌胚抗原（CEA）在胸腔积液中的诊断价值。方法回顾性分析诊断明确的40例结核性胸腔积液、17例肺炎旁胸腔积液和23例癌性胸腔积液患者的临床资料，收集三组患者血清和胸腔积液标本中PCT和CEA含量并进行比较。结果非癌性组胸腔积液中PCT水平均高于癌性组（P〈0．05），肺炎组血清PCT较癌性组明显升高（P〈0．01），结核组血清、胸腔积液中PCT含量与炎性组比较差异无统计学意义。癌性组血清、胸腔积液CEA含量较非癌性组明显升高（P〈0．05）。治疗后结核组和炎性组血清、胸腔积液PCT含量下降（P〈0．05）。炎性组和结核组胸腔积液PCT含量较血清中PCT含量高（P〈0．05）。结论PCT联合CEA的测定对于胸腔积液病因的鉴别有一定的价值，可减少漏诊率。胸腔积液PCT对局部感染程度有一定的提示意义，对于抗感染药物的早期应用有较高的，临床指导价值。

Objective To investigate the diagnostic value of combined detection of procalcitonin （PCT） and carcinoembryonic antigen（CEA） in pleural effusion. Methods The concertrations of PCT and CEA both in serum and pleural fluid in 80 patients with pleura1 effusion were detected. These pa tients were divided into three groups. Forty patients with tuberculous plural effusion were composed of the tuberculous group, 17 patients with parapneumonic plural effusion were composed of the pneunmnic group and 23 patients with malignant pleural effusion. Results The serum and pleural effusion levels of PCT in non-malignant groups were higher than those in the malignant group（P 〈0.01 ）. There were no statisti cally significant differences in serum and pleura1 effusion PCT levels between the tuberculous group and the pneumonic group （P 〉 0.05）. The serum and pleural effusion levels of CEA in malignant groups were higher than those in the non-malignant group （P 〈 0.05 ）. The groups serum and pleura1 effusion levels of PCT in tuberculous and pneumonic were lower than the levels before treatment. Conclusions Combined measurements of PCT and CEA levels in pleural fluid is useful in diagnosing pleural effusion.