外周血NLR、PLR及胸水ADA、LDH在鉴别胸腔积液性质中的应用

Application of peripheral blood NLR,PLR,and pleural effusion ADA,LDH in differen⁃tiating the nature of pleural effusion

目的探究外周血NLR、PLR及胸水ADA、LDH在不同性质胸腔积液中的表达及临床价值。方法选取2019年5月至2020年10月本院收治的结核性胸腔积液组(TPE组,36例)、细菌性胸腔积液组(BPE组,31例)、恶性胸腔积液组(MPE组,33例)共100例患者作为研究对象。比较3组患者生化因子水平。结果 3组外周血PLR水平比较,差异无统计学意义(P>0.05)。TPE组、MPE组外周血NLR水平显著高于BPE组,差异有统计学意义(P<0.05),TPE组胸水ADA水平显著高于BPE组、MPE组,差异有统计学意义(P<0.05),BPE组胸水LDH显著高于TPE组、MPE组,差异有统计学意义(P<0.05)。外周血NLR与胸水ADA、LDH呈正相关(r=0.432,P<0.05)。且联合鉴别AUC均高于各因子单独诊断效果(P<0.05)。结论外周血NLR及胸水ADA、LDH在不同性质胸腔积液中表达有所不同,且可用于鉴别MPE。

Objective To explore the clinical value of the expression of peripheral blood NLR,PLR,and pleural fluid ADA,LDH in different types of pleural effusion.Methods A total of 100 patients in the tuberculous pleural effusion group(TPE group,36 cases),the bacterial pleural effusion group(BPE group,31 cases),and the malignant pleural effusion group(MPE group,33 cases)admitted to our hospital from May 2019 to October 2020 were selected as the research objects.Biochemical factor levels in 3 groups were compared.Results There was no significant difference in the PLR level among 3 groups(P>0.05),the NLR level in peripheral blood of the TPE group and the MPE group was significantly higher than that of the BPE group(P<0.05),the ADA level in pleural fluid of the TPE group was significantly higher than that of the BPE group and the MPE group(P<0.05),and the LDH in pleural fluid of the BPE group was signifi⁃cantly higher than that of the TPE group and the MPE group(P<0.05).Peripheral blood NLR was correlated with ADA and LDH of pleural fluid(r=0.432,P<0.05).The combined differential AUC was higher than that of each factor alone(P<0.05).Conclusion Peripheral blood NLR and pleural fluid ADA,LDH are ex⁃pressed differently in different types of pleural effusion,and can be used to identify MPE.