POEMS综合征胸腔积液细胞学及生化学特点分析

Analysisof the cytological and biochemical characteristics of pleural effusion in patients with POEMS syndrome

目的分析POEMS综合征患者胸腔积液的细胞学及生化学特点。方法回顾性复习和整理北京协和医院进行过胸腔穿刺检查的POEMS综合征患者的一般资料、胸腔积液细胞学检查及生化学检查资料。结果进行过胸腔穿刺检查的确诊POEMS综合征24例。其中男性11例,女性13例。发病时平均年龄为48.63岁,平均病程27.45月。查体阳性(叩浊)率66.67%(16/24)。外观以黄色混浊或微混为主(54.17%,13/24),其次是黄色透明(25.00%,6/24)。胸腔积液白细胞数211.79×106/L,单核为主,占79%。参照Light标准,渗出液占84.21%。结论本文总结的POEMS综合征胸腔积液以渗出液为主,占84.21%(Light标准)。细胞学方面,白细胞数较少,以单核为主。建议临床医生拟诊POEMS综合征时注意核实是否存在胸腔积液及其性质是否典型。

Objective To analyze the cytological and biochemical characteristics of pleural effusion in patients with POEMS syndrome. Methods General information,cytological results,and chemical results of pleural effusion in patients with POEMS syndrome who underwent thoracentesis from Peking Union Medical College Hospitalwere retrospectively reviewed. Results Twenty four patients with POEMS syndrome and thoracentesis were diagnosed. There wre Eleven men and thirteen women. The average onset age was 48. 63 years old,and the average course was 27. 45 months. The positive rate of pulmonary percussion was66. 67%. Gross appearance of pleural effusion was turbid or slightly turbid,and yellow in 54. 17% patients,and clear and yellow in 25. 00% patients. The average WBC count of pleural effusion was 211. 79 × 106/L. Most of the WBCs were lymphocytes. The average percent of lymphocytes was 79%. According to Light criteria of pleural effusion,84. 21% are exudates.Conclusion Pleural effusions in the 24 patients with POEMS syndrome are mostly exudates,accounting for 84. 21%（ Light stamdard）. As for the aspect of cytology,the number of white blood cells was less and most of them are single nucleus,We suggest patients with possible diagnosis of POEMS syndrome should be checked if the pleural effusion exist and if the patients have the typical properties.