目的评价胆固醇酯对腹水鉴别诊断的价值。方法采用酶法测定１１５例各种原因所致腹水中胆固醇酯及溶菌酶的浓度。结果胆固醇酯在恶性腹水中显著升高，与非结核良性腹水比较有显著差异（Ｐ＜０００１），以１５０ｍｇ／Ｌ作为鉴别值，其诊断恶性腹水的阳性率为８０９％，但它不能区别恶性腹水与结核性腹水。而溶菌酶对结核性腹水的诊断有很高的价值。结论同时检测胆固醇酯和溶菌酶，可很好地鉴别各种原因所致的腹水。 Objective To evaluate the value of cholesterol ester in the differential diagnosis of ascites. Methods Enzyme method was used to determine the concentrations of cholesterol esters and lysozyme in ascites due to various reasons. Results Cholesteryl ester increased significantly in malignant ascites and was significantly different from non - tuberculous benign ascites (P <0001). The positive rate of malignant ascites was 809% with 150 mg / L as identification value It can not distinguish between malignant ascites and tuberculous ascites. The lysozyme on the diagnosis of tuberculosis ascites has a high value. Conclusions Simultaneous detection of cholesterol ester and lysozyme can be used to identify ascites due to various causes.