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目的:探讨青年腹水的病因构成及腹水检查对于腹水鉴别诊断的意义。方法:回顾性分析295例青年腹水的病例资料,分析其病因构成及不同病因腹水各指标差异性。结果:青年腹水病因分别为:结核性腹水(32.09%)、恶性腹水(26.78%)、肝硬化腹水(10.17%)及其他。腹水总蛋白(TP)及腺苷脱氨酶(ADA)由高到低及葡萄糖(Glu)由低到高依次为结核性腹水组、恶性腹水组、肝硬化腹水组,3组之间差异皆具有统计学意义(P<0.05或P<0.01);恶性腹水组及结核性腹水组腹水乳酸脱氢酶(LDH)显著高于肝硬化腹水组(P<0.01),而恶性腹水组腹水LDH与结核性腹水组相比差异无统计学意义(P>0.05)。恶性腹水组腹水CA199、CEA、AFP高于良性腹水组,差异具有统计学意义(P<0.01),而腹水CA125差别无统计学意义(P>0.05)。结果:青年腹水主要以结核性腹水为主。腹水高TP、高ADA及低Glu支持结核性腹水诊断,腹水CA199、CEA及AFP等肿瘤标志物异常升高时,支持恶性腹水的诊断,但腹水单项CA125升高时仍应考虑良性腹水的可能性。
Objective: To explore the etiology of young ascites and ascites examination for the differential diagnosis of ascites. Methods: A retrospective analysis of 295 cases of young ascites data to analyze the cause of formation and different causes of ascites different indicators. Results: The causes of ascites were as follows: tuberculous ascites (32.09%), malignant ascites (26.78%), liver cirrhosis (10.17%) and others. Ascites total protein (TP) and adenosine deaminase (ADA) from high to low and Glu (Glu) from low to high ascites tuberculous ascites group, malignant ascites group, liver cirrhosis group, the difference between the three groups (P <0.05 or P <0.01). Ascites lactate dehydrogenase (LDH) in malignant ascites group and tuberculous ascites group was significantly higher than that in cirrhotic ascites group (P <0.01) Tuberculous ascites group was no significant difference (P> 0.05). The levels of CA199, CEA and AFP in malignant ascites group were higher than those in benign ascites group (P <0.01), while there was no significant difference in ascites CA125 (P> 0.05). Results: Young ascites mainly tuberculous ascites. High ascites TP, high ADA and low Glu support tuberculous ascites diagnosis, ascites CA199, CEA and AFP and other tumor markers abnormal increase in support of the diagnosis of malignant ascites, but ascites CA125 elevation should still consider the possibility of benign ascites Sex.