. 2007; 9(1): 17-23 | |||
Plevra sıvılarının eksüda-transüda ayrımında light kriterleri, albümin gradienti, alkalen fosfataz, total kolesterol, total bilirübin ve ürik asit ölçümlerinin karşılaştırmalı analiziFüsun Şahin, Funda Arkın, Firdevs Atabey, Sezai Öztürk, Pınar YıldızYedikule Göğüs Hastalıkları Ve Göğüs Cerrahisi Eğitim Ve Araştırma Hastanesi, Göğüs Hastalıkları, İstanbul, TürkiyeAMAÇ: Plevral sıvıların tanısında, transüda ve eksuda olarak ayırım yapmak ilk basamağı oluşturmaktadır. Transüda-eksuda ayrımında Light kriterlerinin, albumin gradienti, ALP, total kolesterol, total bilirübin ve ürik asit ölçümlerinin değerini araştırmak amaçladı. Comparative analysis of light’s criteria, albumin gradient, alkaline phosphatase, total cholesterol, total bilirubin and uric acid measurements for differentiation of pleural exudates from transudatesFüsun Şahin, Funda Arkın, Firdevs Atabey, Sezai Öztürk, Pınar YıldızYedikule Chest Diseases And Thoracic Surgery Research And Training Hospital, Chest Diseases, İstanbul, Turkeystep in the diagnosis of pleural effusions. MATERIAL-METHOD: Fifty three patients with pleural effusions were included in the study which was made to evaluate the values of Light’s criteria, albumin gradient, alkaline phosphatase(ALP), total cholesterol, total bilirubin and uric acid analysis to discriminate exudates from transudates. Eightteen cases (mean age 61.44±11.81) were grouped as transudates and 35 cases (mean age 40.49±17.44) as exudates. RESULTS: Mean pleural fluid total protein, mean pleura/serum (P/S) total protein ratio, mean pleura LDH, mean p/s LDH ratio, mean albumin gradient, mean pleura ALP, mean pleura total cholesterol, mean p/s total cholesterol ratio, mean p/s total bilirubin ratio, mean pleura uric acid were measured 1.94±0.80 g/dL, 0.29±0.10, 118.83±100 U/L, 0.36±0.22, 2.17±0.81 g/dL, 20.50±14.23, 30.61±19.69 mg/dL, 0.16±0.11, 0.43±0.27, 6.40±1.92 mg/dL in patients with transudates, respectively; 5.09±0.63 g/dL, 0.73±0.08, 541.03±401 U/L, 3.09±2.77, 0.55±0.28 g/dL, 55.17±17.33, 88.40±24.80 mg/dL, 0.59±0.14, 0.87±0.41, 4.73±1.44 mg/dL in patients with exudates, respectively. Significant values for above measurements were found in compared transudates and exudates groups by employing “Student-t Test”(p<0.01). Sensitivity and Specificity: P/S total protein ratio for diagnosis of exudates effusions were %100-%100(cut-off: 0.52),P/S LDH ratio for exudates were %100-%89 (cut-off: 0.61), S-P albumin gradient for diagnosis of transudates were %94-%100 (cut-off: 1.2),pleura ALP for exudates were %77-%95 (cut-off: 42),pleura total cholesterol for exudates were %91-%95 (cut-off: 64), P/S total cholesterol ratio for exudates were %97-%84 (cut-off: 0.33), P/S total bilirubin ratio for exudates were %77-%89 (cut-off: 0.61), pleura uric acid for transudates were %55-%78 (cut-off: 5.5),respectively. CONCLUSION: Our findings indicate that measurements of Light’s criteria, albumin gradient, ALP, total cholesterol, total bilirubin and uric acid in pleural fluid become of diagnostic value in differential diagnosis of transudates and exudates. However, Light’s criteria remain the best method of separating transudates from exudates. Keywords: exudate, pleural effusions, transudate.Füsun Şahin, Funda Arkın, Firdevs Atabey, Sezai Öztürk, Pınar Yıldız. Comparative analysis of light’s criteria, albumin gradient, alkaline phosphatase, total cholesterol, total bilirubin and uric acid measurements for differentiation of pleural exudates from transudates. . 2007; 9(1): 17-23 Sorumlu Yazar: Füsun Şahin, Türkiye |
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