The Study On Determination Of Cholesterol In Pleural Effusion To Differentiating The Nature And Causes Of Pleural Effusion

Objective To evaluate the value of pleural effusion cholesterol in defferentiating the benign and malignant pleural effusion.Methods Collect those patients information hospitalized in the Affiliated Hospital of Yan’an University from December 2014 to December 2016,all the patients were received thoracentesis and collected pleural effusion sample within three days of admission,and fasting blood samples were taken in the morning of the second day.then calculate the P/Sch.Pch,P/Sch of all the patients were devided into sevaral groups and compared the differences,respectively according to gender,age,nature and causes of pleural effusion,then making the receiver operating characteristic curve(ROC curve).Results This study collected 221 cases,including 113 male patients and 108 female patients.45 years of age(~45)with 63 cases,45~65 years of age(~65)72 patients,age moro than 65 years(65~)with 86 patients,malignant pleural effusion in 61 cases,160 cases of benign pleural effusion(84 cases of tuberculosis,18 cases of pneumonia,cardiogenic in 53 cases,2 cases,3 cases of nephrogenic hepatic).1.The causes of pleural effusion in different age groups showed significant difference in the distribution of causes.2.The differences of Pch,P/Sch between the exudative and transudate were significant(2.55±0.08 vs.0.86±0.41、0.63±0.19 vs.0.24±0.18,P<0.01)3.The results of Pch,P/Sch in defferentiating pleural effusion nature analysis showed that the ROC area of Pch,P/Sch respectively was 0.97,0.98,the cutoff of Pch was 1.72,specificity was 0.99,sensitivity was 0.97,and the cutoff value of P/Sch was 0.41,the specificity was 0.98,sensitivity was 0.99.4.Comparison of Pch and P/Sch in different genders by the comparison of benign and malignant showed that the differences in male and female gender were not statistically significant.5.There were no significant difference in Pch,P/Sch between malignant and tuberculous pleural effusion in patients aged ~45,45~65 years(P>0.05).6.The results of comparing Pch,P/Sch in 65~ year old patients groupde by different casuse of pleural effusion show that the difference among malignant pleural effusion group,tuberculosis group and pneumonia group in Pch(2.94±0.6 vs.2.29±0.53 vs.2.31±0.40,P<0.05),P/Sch(0.73±0.10 vs.0.60±0.19 vs.0.61±0.11 P<0.05)were statistically significant,and further comparison between the two groups showed that malignant group of P/Sch,Pch levels were higher than the tuberculosis group,pneumonia group.The differences of Pch,P/Sch between tuberculosis and pneumonia group were no statistically significant.7.There was no linear correlation between Pch and Sch in elderly patients with effusion pleural effusion.8.The results of Pch(P/Sch)in defferentiating the benign and malignant pleural effusion showed that the ROC area respectively was 0.74,0.76 the cutoff of Pch(P/Sch)was 3.18(0.71),specificity and sensitivity were respectivily 0.97(0.83)and 0.78(0.77).Conclusion 1.Pch,P/Sch have higher diagnostic value in defferentiating the nature of pleural effusion,and the sensitivity and specificity are high.2.Pch and P/Sch have no significant value in defferentiating benign and malignant pleural effusion in people under the age of 65,but there are a certain value among the 65~ years in identification of benign and malignant pleural effusion.