CHOLESTEROL - A USEFUL PARAMETER FOR DISTINGUISHING BETWEEN PLEURAL EXUDATES AND TRANSUDATES
CHOLESTEROL - A USEFUL PARAMETER FOR DISTINGUISHING BETWEEN PLEURAL EXUDATES AND TRANSUDATES
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DOI：
10.1378/chest.99.5.1097
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发表时间：
1991-05-01
期刊：
影响因子：
9.6
通讯作者：
SUAREZ, JRR
中科院分区：
文献类型：
--
作者：
VALDES, L;POSE, A;SUAREZ, JRR
根据既往制定的标准，将253例胸腔积液分为漏出液（65例）、肿瘤性渗出液（67例）、结核性渗出液（65例）或杂项渗出液（56例）。 将参数胸膜 LDH (PLDH)、胸膜 LDH/血清 LDH 比值 (P/SLDH) 和胸膜蛋白/血清蛋白比值 (P/SPROT) 与胸膜胆固醇 (PCHOL) 和胸膜胆固醇/血清胆固醇比值 (P/SCHOL) 进行比较，了解其区分胸膜渗出物和漏出物的有用性。 确定的 PCHOL 值：漏出液为 28.5 +/- 12.8 mg/dl，肿瘤性渗出液为 88.1 +/- 30 mg/dl，结核性渗出液为 96.5 +/- 28 mg/dl，杂项组为 88 +/- 35.9 mg/dl；漏出液组与其他组之间的差异具有统计学意义（p < 0.001）。 P/SPROT 诊断渗出液的敏感性和特异性均为 89%； PLDH的敏感性为67%，特异性为95%； P/SLDH的敏感性和特异性均为84.6%。 使用 Light 的三个标准作为电池，灵敏度为 94.6%，特异性为 78.4%。 所有漏出液以及 188 份渗出液中的 17 份（9%）PCHOL 值低于 55 mg/dl，因此在该阈值下，PCHOL 对渗出液诊断的敏感性为 91%，特异性为 100%。 阈值为 0.3 时，P/SCHOL 的敏感性为 92.5%，特异性为 87.6%。 PCHOL 的错误分类数量少于任何其他参数，与 PLDH (p < 0.001) 和 P/SLDH (p < 0.01) 相比具有统计显着性差异。 我们的结论是，PCHOL 和 P/SCHOL 的测定对于区分胸腔渗出液和漏出液具有重要价值，应纳入胸腔积液的常规实验室分析中。
Previously established criteria were used to classify 253 pleural effusions as transudates (65 cases), neoplastic exudates (67 cases), tuberculous exudates (65 cases), or miscellaneous exudates (56 cases). The parameters pleural LDH (PLDH), pleural LDH/serum LDH ratio (P/SLDH), and pleural protein/serum protein ratio (P/SPROT) were compared with pleural cholesterol (PCHOL) and the pleural cholesterol/serum cholesterol ratio (P/SCHOL) with regard to their usefulness for distinguishing between pleural exudates and transudates. The PCHOL values determined were 28.5 +/- 12.8 mg/dl for transudates, 88.1 +/- 30 mg/dl for neoplastic exudates, 96.5 +/- 28 mg/dl for tuberculous exudates, and 88 +/- 35.9 mg/dl for the miscellaneous group; the differences between the transudate group and the others are statistically significant (p < 0.001). The sensitivity and specificity of P/SPROT for diagnosis of exudates were both 89 percent; the sensitivity of PLDH was 67 percent and its specificity was 95 percent; the sensitivity and specificity of P/SLDH were both 84.6 percent. Using Light's three criteria as a battery, the sensitivity was 94.6 percent and its specificity was 78.4 percent. All the transudates and 17 (9 percent) of the 188 exudates had PCHOL values below 55 mg/dl, so that with this threshold, PCHOL had a sensitivity of 91 percent and a specificity of 100 percent for diagnosis of exudates. With a threshold of 0.3, P/SCHOL had a sensitivity of 92.5 percent and a specificity of 87.6 percent. The number of misclassifications by PCHOL was less than with any other of the parameters, with statistically significant differences with respect to PLDH (p < 0.001) and P/SLDH (p < 0.01). We conclude that determination of PCHOL and P/SCHOL is of great value for distinguishing between pleural exudates and transudates, and should be included in routine laboratory analysis of pleural effusions.