胸腔积液诊疗研究进展与生物标志物应用

杨 竑, 董 璇*
华中科技大学同济医学院附属武汉金银潭医院(结核病科);湖北省传染病临床医学研究中心

摘要


胸腔积液是临床常见的呼吸系统疾病并发症,指胸膜腔内液体积聚超过正常生理范围,其本质是胸膜腔内
液体的产生与吸收平衡被打破,导致液体异常潴留的病理状态。作为多种疾病的重要临床表现,胸腔积液的病因复
杂多样,临床诊疗难度较大。随着医学技术的不断发展,尤其是生物标志物的逐步发现,胸腔积液的病因鉴别取得
了显著突破,但临床中漏诊、误诊及治疗效果不佳的问题仍时有发生。本文结合近年来国内外相关研究进展,对胸
腔积液进行系统综述,重点探讨生物标志物与结构性胸腔积液的关联,为临床诊疗提供参考依据,同时为后续相关
研究指明方向。

关键词


胸腔积液;生物学标志物;诊断

全文:

PDF


参考


[1]张晓宏,任寿安.胸腔积液及其引流引发的病理

生理学效应[J].国际呼吸杂志,2021,41(12):956-960

[2]中华医学会呼吸病学分会胸膜与纵隔疾病学组

(筹).胸腔积液诊断的中国专家共识[J].中华结核和呼吸

杂志,2022,45(11):1080-1096

[3]LIGHT R W, MACGREGOR M I, LUCHSINGER

P C, et al. Pleural effusions: the diagnostic separation of

transudates and exudates[J]. Annals of Internal Medicine,

1972, 77(4): 507-513

[4]PIRAS M A, GAKIS C, BUDRONI M, et al.

Adenosine deaminase activity in pleural effusions: an aid

to differential diagnosis[J]. British Medical Journal, 1978,

2(6154): 1751-1752

[5]MARTÍNEZ-ESPINOSA I, SERRATO J A,

CABELLO-GUTIÉRREZ C, et al. Exosome-Derived

miRNAs in Liquid Biopsy for Lung Cancer[J]. Life (Basel),

2024, 14(12): 1608

[6]魏黛珏,同重湘.胸腔积液腺苷脱氨酶、全血γ-

干扰素和白细胞介素2检测对结核性胸膜炎的诊断价值

[J].结核与肺部疾病杂志,2025,6(5):525-531

[7]李 威, 陈 燕 明, 陈 晓 军, 等.胸 腔 积 液 中

miRNA-21和miRNA-155表 达 的 诊 断 价 值[J].江 苏 医

药,2012

[8]陈小蓉,曾惠清,王洺辉,等.生物学标志物在

渗出性胸腔积液诊断的研究进展[J].中国呼吸与危重监护

杂志,2021,20(2):148-152

[9]JANKOVIC J, ILIC B, DURDEVIC N, et al. ADA

as main biochemical marker in patients with tuberculous

effusion[J]. Journal of Medical Biochemistry, 2023, 42(4):

722-726

[10]ZENG T, LING B, HU X, et al. The Value of

Adenosine Deaminase 2 in the Detection of Tuberculous

Pleural Effusion: A Meta-Analysis and Systematic Review[J].

Canadian Respiratory Journal, 2022, 2022: 7078652

[11]谭慧,王璞.免疫指标在结核性胸腔积液诊断中

的研究进展[J].西部医学,2024,36(01):152-156

[12]HUANG H, LI Y, CAO X, et al. Diagnostic value

of IFN-gamma in tuberculous pleural effusion[J]. Cytokine,

2024, 184: 156773

[13]CHAN F K, MORIWAKI K, DE ROSA M J.

Detection of necrosis by release of lactate dehydrogenase

(LDH) activity[J]. Methods Mol Biol, 2013, 979: 65-70

[14]彭赛亮,何方方,赵年贵.多指标联合检测诊断

结核性胸膜炎的临床价值[J].江西医药,2019,54(12):

1555-1558

[15]GAO L, WANG W, ZHANG Y, et al. Adenosine

deaminase-based measurement in the differential diagnosis

of pleural effusion: a multicenter retrospective study[J]. Ther

Adv Respir Dis, 2023, 17: 17534666231155747

[16]HUANG H, LI Y, ZHANG L, et al. A new strategy

for the diagnosis of tuberculosis based on secreted antigens:

evaluation of the efficacy of alveolar lavage ESAT-6 and

CFP-10 tests[J]. European Journal of Medical Research,

2025, 30: 1171

[17]KOTRULEV M, GOMEZ-TOURIÑO I,

CORDERO O J. Soluble CD26: from suggested biomarker

for cancer diagnosis to plausible marker for dynamic

monitoring of immunotherapy[J]. Cancers (Basel), 2024,

16(13): 2427

[18]OSHIKAWA K, SUGIYAMA Y. Elevated soluble

CD26 levels in patients with tuberculous pleurisy[J]. Int J

Tuberc Lung Dis, 2001, 5(9): 868-872

[19]SÁNCHEZ-OTERO N, RODRÍGUEZBERROCAL F J, DE LA CADENA M P, et al. Evaluation

of pleural effusion sCD26 and DPP-IV as diagnostic

biomarkers in lung disease[J]. Sci Rep, 2014, 4: 3999

[20]KÜPELI E, KARNAK D, ELGÜN S, et al.

Concurrent measurement of adenosine deaminase anddipeptidyl peptidase IV activity in the diagnosis of tuberculous

pleural effusion[J]. Diagn Microbiol Infect Dis, 2009, 65(4):

365-371

[21]黄毓东,谢灿茂.肿瘤坏死因子、白细胞介素

8、可溶性细胞间粘附分子1和CD11b/CD18在良恶性胸

腔积液的价值[J].中华结核和呼吸杂志,2001,24(1):

15-18

[22]何菁,许文芳,陈能松,等.联合检测肿瘤坏死

因子α和白细胞介素6对结核性胸膜炎与恶性胸腔积液

的鉴别诊断价值[J].中国临床保健杂志,2023,26(5):

671-673

[23]张伟,李明,王芳,等.多项指标联合检测在结

核性胸膜炎诊断中的临床价值[J].实用医学杂志,2015,

31(3):407-409

[24]SANTOS A P, CORRÊA R D S, RIBEIROALVES M, et al. Application of Venn's diagram in the

diagnosis of pleural tuberculosis using IFN-γ, IP-10 and

adenosine deaminase[J]. PLoS ONE, 2018, 13(8): e0202481

[25]张建荣,师志云,席向红,等.CEA、CA125、

CA199检测在良恶性胸腔积液鉴别诊断中的应用[J].宁夏

医科大学学报,2010,32(3):418-420

[26]WANG Y, LI X, CHEN H, et al. Performance

evaluation of Eu3+-based CRP/SAA and PCT/IL-6 lateral

flow immunoassay kits and their diagnostic value in respiratory

tract infections[J]. Practical Laboratory Medicine, 2024, 42:

e00432


Refbacks

  • 当前没有refback。