New criteria for the differentiation between transudates and exudates.
New criteria for the differentiation between transudates and exudates.
复制标题
区分漏出液和渗出液的新标准。
DOI：
10.1136/jcp.55.1.69
复制
发表时间：
2002
影响因子：
3.4
通讯作者：
J. Barron
中科院分区：
文献类型：
--
作者：
N. S. Paramothayan;J. Barron
旨在
研究液体中的胆固醇和乳酸脱氢酶（LDH）测量值是否是临床证实的区分渗出液和漏出液的更敏感和特异性标志物，而不是单独测量液体总蛋白浓度。
患者/方法
回顾性分析61例腹膜透析患者的血清、胸水和腹水中LDH、胆固醇和总蛋白。通过审查临床详细信息和实验室数据，独立得出漏出液或渗出液的临床分类。
结果
在54份样本（40份胸腔积液和14份腹水）中，30份被临床分类为渗出液，24份被分类为漏出液。液体LDH和液体与血清蛋白质比值测量在区分渗出液和漏出液方面同样出色，灵敏度为90%，特异性为79%，阳性预测值（PPV）为84%，阴性预测值（NPV）为86%。这些参数的组合将灵敏度提高到100%，NPV提高到100%，但将特异性降低到71%，PPV降低到81%。这种组合实现了比Light标准更高的效率。
结论
常规测量液体LDH值和计算液体与血清总蛋白比值有助于区分渗出液和漏出液。
AIMS
To investigate whether cholesterol and lactate dehydrogenase (LDH) measurements in fluids are more sensitive and specific markers for differentiating between exudates and transudates, as confirmed clinically, than the measurement of fluid total protein concentrations alone.
PATIENTS/METHODS
Serum, pleural fluid, and ascitic fluid from 61 unselected patients were analysed retrospectively for LDH, cholesterol, and total protein. Clinical classification of transudate or exudate was reached independently by reviewing clinical details and laboratory data.
RESULTS
Of 54 samples (40 pleural fluid and 14 ascitic fluid), 30 were classified clinically as exudates and 24 as transudates. Fluid LDH and fluid to serum protein ratio measurements were equally good at differentiating between exudates and transudates, with a sensitivity of 90%, a specificity of 79%, a positive predictive value (PPV) of 84%, and a negative predictive value (NPV) of 86%. A combination of these parameters improved sensitivity to 100% and NPV to 100%, but lowered the specificity to 71% and PPV to 81%. This combination achieved a higher efficiency than Light's criteria.
CONCLUSION
Routine measurement of fluid LDH values and the calculation of fluid to serum total protein ratios will aid in differentiating exudates from transudates.