乳酸脱氢酶及其同工酶分析对胸腔积液鉴别的诊断价值

目的研究乳酸脱氢酶及其同工酶分析对胸腔积液鉴别的诊断价值.方法用日本HITACHI747型全自动生化分析仪及美国Helena公司全自动快速电泳系统检测121例胸腔积液乳酸脱氢酶及其同工酶,对测定结果进行统计学分析.结果121例胸腔积液中,渗出液乳酸脱氢酶活性明显高于漏出液(P＜O.01);乳酸脱氢酶同工酶谱与血清中同工酶谱有差异,即胸腔积液中LDH同工酶以LDH4、LDH5为主.不同原因引起的胸腔积液中乳酸脱氢酶同工酶谱有不同的表现,尤其在渗出液中,乳酸脱氢酶同工酶谱则出现多种改变.典型的表现可分为5种.结论乳酸脱氢酶及其同工酶的检测对渗出性和漏出性胸腔积液的鉴别有重要价值;同时,对不同原因引起的渗出性胸腔积液也有重要的鉴别意义.

Value of analyzing lactate dehydrogenase and its isoenzyme for diagnosis of pleural effusion

Objective: To determine the value of lactate dehydrogenase (LDH) and its isoenzyme in the differential diagnosis of pleural effusion.Methods: LDH and its isoenzyme in pleural effusions of 121 patients measured using Automatic Biochemistry Analyzer of HITACHI and Automatic Rapid Electrophoresis of Helena Company,and the results were analyzed with statistics. Results:In all 121 pleural effusions, the contents of total LDH were significantly higher in exudates than those in transudates (P<0.01). LDH isoenzymes diagram in pleural effusion differed from that in serum, namely, LDH 4 and LDH 5 being the main isoenzyme in the former. There were different isoenzymic patterns in pleural effusion deriving from different causes. And there were many kinds of types in exudates especially. Five types of isoenzymes patterns were found typically in pleural effusion.Conclusion:LDH and its isoenzyme are useful parameters in distinguishing exudates from transudates; meanwhile, they may be helpful in the differential diagnosis of most exudates.