可溶性指标对于胸腔积液鉴别诊断的价值施焕中

可溶性指标对于胸腔积液鉴别诊断的价值,首都医科大学附属北京朝阳医院北京呼吸疾病研究所施焕中,Ann Intern Med 1972; 77: 507-513,2015-5-18,Respiration DOI:10.1159/000435962,Cause distribution of pleural effusions (n = 833),Respiration DOI:10.1159/000435962,Chest 2015; 147: 1395-1400,系统评价多种肿瘤标志物对于鉴别诊断恶性胸腔积液的临床价值，不能依靠单独或联合检测多种肿瘤标志物确诊恶性胸腔积液，但联合检测多种指标的敏感度高于其中的任一种。,Respir Med 2015; doi:10.1016/j.rmed.2015.06.008,Figure 1: Images taken from patients with tuberculous pleurisy using medical thoracoscope showing A) tuberculous nodules with irregular distribution on parietal pleura; B) tuberculous nodules on parietal (upper) and visceral (bottom) pleura; C) multiple military tuberculous nodules on parietal pleura; D) diffused parietal pleura nodules and pleural adhesions; E) parietal pleural hyperemia with necrosis of the pleural node; F) parietal pleural hyperemia with white pleural plaques.,Respir Med 2015; doi:10.1016/j.rmed.2015.06.008,Figure 2: Representative tuberculosis pathology seen in pleural biopsy specimen from two patients with tuberculous pleural effusion. A) epithelioid cell granulomas are seen on the parietal pleurat; B) a acid-fast bacillus (arrow) is seen within the granulomas; C) the view shows the presence of caseating necrosis in the parietal pleura with scattered multinucleated giant cells; D) a acid-fast bacillus (arrow) is seen within the caseating necrosis. Panels A and C, hematoxylin and eosin staining; original magnification: 200. Panels B and D, Ziehl-Neelsen staining; original magnification: 400. Panels A and B are taken from the same patient; Panels C and D are taken from another patient.,Respir Med 2015; doi:10.1016/j.rmed.2015.06.008,系统评价IFN-和腺苷脱氨酶等对于诊断结核性胸膜炎的临床价值，显示IFN-和腺苷脱氨酶是诊断结核性胸膜炎的可靠指标，为临床应用这些诊断指标提供确切的循证医学依据。,Eur Respir J 2005; 25: 605611,Clin Cancer Res 2009; 15: 2231-2237,J Immunol 2010; 185: 6348-6354,Chest 2007; 131: 1133-1141,Respir Med 2008; 102: 744-754,PLoS ONE 2012; 7: e40450,PLoS ONE 2012; 7: e40450,Chin Med J 2013; 126: 3215-3221,中华医学杂志 2014; 94: 2641-2644,Respir Care 2014; 59: 399405,PLoS ONE 2012; 7: e40450,Tuberculosis 2014; 94: 579-588,Tuberculosis