The composition of normal pericardial fluid and its implications for diagnosing pericardial effusions
The composition of normal pericardial fluid and its implications for diagnosing pericardial effusions
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DOI：
10.1016/j.amjmed.2005.01.066
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发表时间：
2005-06-01
影响因子：
5.9
通讯作者：
Livneh, A
中科院分区：
文献类型：
--
作者：
Ben-Horin, S;Shinfeld, A;Livneh, A
背景技术背景：在心包穿刺术中获得的心包液通常进行生化和血液学分析，并使用从胸腔积液中借来的标准进行解释。然而，这种方法的有效性和诊断率是不确定的。此外，有很少的数据关于生理性心包液的正常组成，这可以作为一个参考病理effusions.METHODS：心包液从30例择期心脏直视手术收集。诊断如果患者有已知的心包疾病，有已知的与心包疾病相关的全身性疾病，或者如果液体样本是溶血性的，则排除患者。使用标准的实验室技术的流体的生化和血液学参数进行测定，并与同时抽取静脉blood.RESULTS：研究人群的中位年龄为64.5 +/- 10.6岁所获得的结果进行比较。可溶性分子的化学结果与液体的血浆超滤液性质一致。然而，液体乳酸脱氢酶（LDH）水平出乎意料地高，平均为血清水平的2.4倍，平均蛋白质水平为血清水平的0.6倍。未发现患者合并症与液体特征之间存在相关性。液体中平均含有1430个白细胞/μ L，分类计数主要为淋巴细胞（53.2 +/- 14%）和单核细胞（11.6 +/- 6%）。结论：生理性心包液的成分显著高LDH和蛋白质含量，淋巴细胞占优势。因此，用于诊断胸腔积液的生化标准可能不适用于鉴别漏出性心包积液和渗出性心包积液，淋巴细胞增多症应谨慎解释。(c)2005年爱思唯尔公司All rights reserved.
BACKGROUND: Pericardial fluid obtained at pericardiocentesis is often subjected to biochemical and hematological analysis, and interpreted using criteria borrowed from pleural effusions. However, the validity and diagnostic yield of this approach is uncertain. Moreover, there is little data regarding the normal composition of the physiological pericardial fluid, which could serve as a reference for pathological effusions.METHODS: Pericardial fluid from 30 patients undergoing elective open heart surgery was collected. Diagnosis Patients were excluded if they had known pericardial disease, had systemic disorders known to be, associated with pericardial disease, or if the fluid samples were hemolytic. The biochemical and hematological parameters of the fluid were determined using standard laboratory techniques, and compared with the results obtained for concurrently drawn venous blood.RESULTS: The median age of the study population was 64.5 +/- 10.6 years. Chemistry results of soluble molecules were consistent with the plasma ultrafiltrate nature of the fluid. However, fluid lactate dehydrogenase (LDH) level was unexpectedly high, averaging 2.4 times the serum level, and the mean protein level was 0.6 of the serum level. No correlation was found between comorbidities of patients and fluid characteristics. Fluids contained an average of 1430 leukocytes/mu L, with a differential count that was predominated by lymphocytes (53.2 +/- 14%) and monocytes (11.6 +/- 6%).CONCLUSIONS: The composition of the physiologic pericardial fluid is remarkable for high LDH and protein content, and for predominance of lymphocytes. Thus, the biochemical criteria useful for diagnosing pleural effusions are probably not applicable for differentiating transudative from exudative pericardial effusions, and lymphocytosis should be interpreted cautiously. (c) 2005 Elsevier Inc. All rights reserved.