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目的探讨腹水待查患者腹水病因构成及血清肿瘤标记物、腹水常规检查对良恶性腹水鉴别诊断的临床意义。方法选取2013年1月至2014年12月新疆医科大学第一附属医院收治的191例不明原因腹水患者的临床资料进行回顾性分析。结果 (1)191例患者中,结核性腹膜炎46.6%,恶性肿瘤28.3%,肝硬化14.1%,其他病因腹水11%。(2)汉族、维族腹水病因构成比差异有统计学意义(P<0.05),青年、中年、老年腹水病因构成比差异有统计学意义(P<0.05),男性、女性腹水病因构成比差异无统计学意义(P>0.05)。(3)血清癌抗原(CA153)、血清CA125、血清清蛋白、红细胞沉降率、C反应蛋白、腹水蛋白、腹水细胞数平均值在良恶性腹水中差异无统计学意义(P>0.05);血清CA199、血清癌胚抗原(CEA)、腹水腺苷脱氢酶(ADA)、腹水乳酸脱氢酶(LDH)平均值在良恶性腹水中差异有统计学意义(P<0.05)。结论不同地区、不同民族及不同年龄腹水病因构成不同,联合检测血清肿瘤标记物及腹水常规检查、影像学、病理学检查对良恶性腹水鉴别诊断有一定意义。
Objective To investigate the etiology of ascites due to ascites and clinical significance of differential diagnosis of benign and malignant ascites due to routine examination of serum tumor markers and ascites. Methods The clinical data of 191 patients with unexplained ascites admitted to the First Affiliated Hospital of Xinjiang Medical University from January 2013 to December 2014 were retrospectively analyzed. Results (1) Of the 191 patients, tuberculous peritonitis was 46.6%, malignant tumor was 28.3%, cirrhosis was 14.1%, and other causes were ascites 11%. (2) There were significant differences in the etiology of ascites between Han and Uighurs (P <0.05), and the differences in the constituent ratios of ascites in young, middle-aged and elderly patients were statistically significant (P <0.05) No statistical significance (P> 0.05). (3) There was no significant difference in mean value of CA125, serum CA125, serum albumin, erythrocyte sedimentation rate, C-reactive protein, ascites protein and ascites cells in benign and malignant ascites (P> 0.05) There was significant difference between the mean of CA199, CEA, ADA and LDH in benign and malignant ascites (P <0.05). Conclusions The etiology of ascites in different regions, ethnic groups and different ages is different. The combination of serum tumor markers and ascites routine examination, imaging and pathological examination have certain significance in the differential diagnosis of benign and malignant ascites.