联合检测CEA、Tch和ADA对腹水病因的鉴别诊断价值
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Combined Determination of CEA, Tch and ADA for Differential Diagnosis of Ascites
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    摘要:

    目的:研究联合检测腹水中癌胚抗原(CEA)、总胆固醇(Tch)和腺苷脱氨酶(ADA)等指标对腹水病因诊断和鉴别诊断的价值.方法:根据病因将68例腹水患者分为恶性腹水、结核性腹水和非结核性良性腹水三组.检测和分析不同腹水中CEA、Tcb和ADA等指标的特点.结果:CEA在恶性腹水组中明显高于良性腹水组,诊断恶性腹水的敏感性和特异性分别为50%和100%.Tch在结核性腹水组中(1.54 mmol/L,而在非结核良性腹水组中≤1.18 mmol/L,恶性腹水组的Tch水平多介于结核性和非结核性良性腹水之间.腹水ADA>30 U/ml者在结核性腹水组中占80%,而非结核性良性腹水组的患者均低于此值.结论:CEA、Tch和ADA对腹水病因的诊断和鉴别诊断有重要价值,联合检测能提高腹水性质的诊断水平.

    Abstract:

    Objective: To study the value of combined determination of carcinoembryonic antigen (CEA), total cholesterol (Tch) and adenosine deaminase (ADA) in the differential diagnosis of ascites due to different causes. Methods: Sixty-eight cases with ascites were divided into 3 groups based on their etiology, namely malignant ascites, tubercular ascites and non-tubercular benign ascites. CEA, Tch, and ADA were measured and analyzed in different ascites.Results: CEA was significantly higher in malignant ascites than in benign ascites, the sensitivity and spedfidty for malignant ascites being 50% and 100% respectively. Tch is higher or equal to 1.54 mmol/L in tubercular ascites and lower or equal to 1.18 mmol/L in non-tubercular benign ascites, and Tch level in malignant ascites was frequently between that in tubercular acites and non-tubercular benign ascites. Ascitic fluid ADA activity was higher than 30 U/L in 80% of tubercular ascites, while none of non-tubercular benign ascites reached to such level. Conclusion: CEA, Tch and ADA are valuable for the diagnosis and differential diagnosis of ascitic etiology and combine measurements of these indices can increase the diagnostic efficiency.

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华国平,高岩,倪润洲.联合检测CEA、Tch和ADA对腹水病因的鉴别诊断价值[J].南京医科大学学报(自然科学版),2004,18(6):

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