淋巴瘤合并乳糜胸胸腔积液分析

Analysis on the Characteristics of Pleural Fluid in Patients with Chylothorax Complicated by Lymphoma

目的通过分析淋巴瘤合并乳糜胸患者胸腔积液的特点,为胸腔积液的诊断提供帮助。方法收集2008年6月至2013年5月北京军区总医院收治的8例淋巴瘤合并乳糜胸患者的临床资料,回顾性分析其胸腔积液实验室检查数据,包括胸腔积液常规和生化检测。结果按照渗出液和漏出液的诊断标准,7例患者的胸腔积液属于渗出液,患者渗出液中蛋白水平均升高,其中合并乳酸脱氢酶升高者1例,患者合并曲霉菌肺炎;1例患者的胸腔积液属于漏出液,患者合并充血性心力衰竭。结论淋巴瘤合并乳糜胸患者胸腔积液检测总体上符合渗出液的标准,以蛋白升高为主。乳酸脱氢酶升高提示可能合并肺炎旁积液,若蛋白升高未到达渗出液诊断标准时可能有漏出液因素参与。

Objective To analyze the characteristics of pleural fluid in patients with lymphoma complicated by chylothorax,in order to provide guidance for the diagnosis of pleural effusion. Methods Eight patients with chylothorax complicated by lymphoma admitted to General Hospital of Chinese PLA Beijing Command from June. 2008 to May 2013 were collected. Their laboratory test data of pleural effusion,including hydrothorax common test data and biochemical test data,was retrospectively analyzed. Results According to diagnostic criteria,pleural effusions of seven cases out of the eight belonged to exudate,and the protein levels of the effusions were all increased,one case among the seven was a patient complicated by aspergillus pneumonia,with the level of lactate dehydrogenase risen. Pleural effusion of one case out of the eight belonged to transudate,and the patient was complicated by congestive heart failure. Conclusion In general,the pleural effusion test results of patients with chylothorax complicated by lymphoma accord with the criteria of transudate,mainly presented by the increased protein level. Increasing LDH concentration in pleural fluid may suggest parapneumonic effusion complication. Increased protein level that fails to meet the criteria of exudate may suggest that transudate could be involved.