资源描述
,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,*,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,*,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,*,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,*,可溶性指标对于胸腔积液鉴别诊断价值施焕中,Ann Intern Med 1972; 77: 507-513,2015-5-18,Cause,n (%),Cause,n (%),Benign diseases,429 (51.5),Malignancies,342 (41.1),Tuberculosis,333 (77.6),Metastatic cancers,272 (79.5),Bacterial infection,36 (8.4),Mesothelioma,35 (10.2),Chylothorax,6 (1.4),Lymphoma,10 (2.9),Chemical pleurisy,4 (0.9),Undetermined,25 (7.3),Other exudates,33 (7.7),Undiagnosed,62 (7.4),Transudates,17 (4.0),Cause distribution of pleural effusions (n = 833),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。,Thorax 2008; 63: 35-41.,目前尚无证据表明单一肿瘤标志物可用于诊断,MPE,。,Respir Med 2010; 104: 149-156,.,间皮素诊断恶性胸膜间皮瘤的敏感度、特异度、阳性似然比、阴性似然比分别为,64,%,、,89,%,、,7.10,、,0.39,。,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.,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.,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。,Chest 2007; 131: 1133-1141.,IF = 7.132,他引,66,次,IFN-,诊断,TPE,的敏感度、特异度、阳性似然比、阴性似然比分别为,89,%,、,97,%,、,23.45,、,0.11,。,Respir Med 2008; 102: 744-754.,IF = 2.917,他引,69,次,ADA,诊断,TPE,的敏感度、特异度、阳性似然比、阴性似然比分别为,92%,、,90%,、,9.03,、,0.10,。,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 2014; 94: 579-588,Tuberculosis 2014; 94: 579-588,Tuberculosis 2014; 94: 579-588,人有了知识，就会具备各种分析能力，,明辨是非的能力。,所以我们要勤恳读书，广泛阅读，,古人说“书中自有黄金屋。,”通过阅读科技书籍，我们能丰富知识，,培养逻辑思维能力；,通过阅读文学作品，我们能提高文学鉴赏水平，,培养文学情趣；,通过阅读报刊，我们能增长见识，扩大自己的知识面。,有许多书籍还能培养我们的道德情操，,给我们巨大的精神力量，,鼓舞我们前进,。,人有了知识，就会具备各种分析能力，,明辨是非的能力。,所以我们要勤恳读书，广泛阅读，,古人说“书中自有黄金屋。,”通过阅读科技书籍，我们能丰富知识，,培养逻辑思维能力；,通过阅读文学作品，我们能提高文学鉴赏水平，,培养文学情趣；,通过阅读报刊，我们能增长见识，扩大自己的知识面。,有许多书籍还能培养我们的道德情操，,给我们巨大的精神力量，,鼓舞我们前进,。,
展开阅读全文