Study on multiple-index joint inspection in diagnosis of exudative and transudatory pleural effusion

Abstract

Objective To inspect pleural effusion cholesterol (PE CHOL),ratio of pleural effusion cholesterol and serum cholesterol (P/S CHOL),pleural effusion C-reactive protein (PE CRP) and serumeffusion albumin gradient (SEAG) to appraise the value of the multiple-index joint inspection in the diagnosis of the exudative and the transudatory pleural effusion.Methods 137 patients with different causes of pleural effusion were divided into transudate group and exudate group.Various indexes related to pleural effusion were inspected in parallel.ROC curve was obtained by analyzing the data of the statistics.Results The ratio of pleural effusion protein and serum protein,ratio of pleural effusion lactate dehydrogenase and serum lactate dehydrogenase,and pleural effusion lactate dehydrogenase in the exudative pleural effusion were higher than those in the transudatory pleural effusion (all P ＜ 0.05).According to the Light standard,the sensitivity and specificity were 99％ and 81％.PE CHOL,P/S CHOL,and PE CRP in the exudative pleural effusion were higher than those in the transudatory pleural effusion (all P ＜0.05).According to ROC curve,the determined diagnostic cutoff points were PE CHOL＞1.52 mmol/L,P/S CHOL＞0.32,and PE CRP＞20 mg/L,the sensitivity were 93％,98％and 93％,the specificity were 89％,91％ and 91％,respectively.SEAG in the exudative pleural effusion was lower than that in the transudatory pleural effusion (P ＜0.05).According to ROC curve,the determined diagnostic cutoff point was SEAG＜10 g/L,the sensitivity and specificity were 81％ and 91％,respectively.Conclusions The multiple-index joint inspection in the differential diagnosis is of great value.Compared with the Light standard,it has higher specificity. Key words: Exudate; Transudate; Pleutal effusion; Multiple indicator ; Identification