80岁以上老年患者胸腔积液病因分析

Analysis on the Etiologies of Patients Over Eighty with Pleural Effusion

目的通过胸腔积液病因分析,探讨高龄患者胸腔积液特点,为病因诊断提供帮助。方法收集2006年6月至2012年6月北京军区总医院收治的80岁以上胸腔积液患者120例的临床资料,对其病因分布和临床特点进行归纳分析。其中45例患者进行了胸腔积液N端脑钠肽前体(NT-proBNP)检测,24例为慢性心功能衰竭患者(慢性心功能衰竭组),21例为正常心功能患者(对照组),比较两组患者的NT-proBNP水平。结果 120例患者中心功能不全39例,恶性胸腔积液33例,肺炎旁积液21例,结核性胸膜炎9例,其余病因及诊断不明者18例。心功能不全组中胸腔积液NT-proBNP显著高于对照组(P<0.05)。结论 80岁以上老年患者中,慢性心功能不全、恶性肿瘤、肺炎旁积液是胸腔积液的主要病因。胸腔积液NT-proBNP升高有助于慢性心功能衰竭诊断。

Objective To explore the characteristics of plcural effusion of elderly patients by analyzing the causes of pleural effusion among patients over the age of eighty, in order to contribute to the etiological diagnosis. Methods Clinical data of 120 elderly patients over the age of eighty with pleural effusion hospitalized during Jun. 2006 to Jun. 2012 was collected and analyzed retrospectively. A total of 45 patients took the test of the concentration of NT-pro-BNP in pleural fluid, among which 24 patients suffered from congestive heart failure（ congestive heart failure gourp）and 21 patients had normal heart function （control group）. Results The etiology of 120 eases of pleural effusion were as follows： chronic heart failure （CHY）in 39 eases, malignant pleural effusion in 33 eases, parapneumonic effusion in 19 eases, tuberculous pleurisy in 9 eases, unknown etiology and other causes in 18 cases. The concentration of NT-pro-BNP in patients with CHF was significantly higher than that in the control group （ P 〈 0.05 ）. Conclusion The major etiologies of patients over the age of eighty with pleural effusion are CHF, malignant tumor and parapneumonic effusion. Detection of NT-pro-BNP in pleural fluid contributes to the diagnosis of CHF.