目的：探讨胸水常规细胞形态学检查对鉴别良恶性胸水的价值以及胸水超敏C反应蛋白检测对炎症性胸水和非炎症性胸水鉴别的临床意义。方法：对收集的490例胸水标本进行胸水常规项目检查，离心涂片后用瑞氏染色进行细胞形态学镜检，采用全自动生化分析仪测定胸水中超敏C反应蛋白含量，比较两组胸水中超敏C反应蛋白的含量。结果：肿瘤组胸水中检出恶性细胞200例，阳性率为91％。炎症性胸水中WBC含量为P50＝450．00，肿瘤性胸水中为P50＝1750．00，差异有统计学意义（ P＜0．01）。炎性组胸水超敏C反应蛋白水平为P50＝15．87，肿瘤组为P50＝10．07，差异无统计学意义（ P＞0．05）。结论：胸水进行细胞形态学检查十分重要，对恶性胸水的鉴别诊断有良好的特异性和灵敏度，胸水WBC计数对胸水的鉴别诊断也有一定的临床意义，即肿瘤性与炎症性胸水相比，其值相对较高。而胸水超敏C反应蛋白水平检测未能说明对胸水的鉴别意义。%Objective :To discussion the clinical significance of detection of pleural effusion routine cell morphological examination in the differential diagnosis of benign and malignant pleural effusion and the value of high‐sensitivity C‐re‐active protein on inflammatory hydrothorax and non inflammatory hydrothorax identification .Methods :Routine exami‐nation on 490 cases of pleural effusion collected ,the centrifugal smear with Swiss staining was performed for cell mor‐phology was determined by microscopic examination ,C‐reactive protein content of hypersensitivity C in pleural effusion of automatic biochemical analyzer ,the content of high sensitive C‐reactive protein were compared between the two groups in pleural effusion the .Results:220 cases of hydrothorax proven malignant pleural effusion group ,200 cases of malignant cells can be detected ,the positive rate was 91% .The content of WBC in pleural fluid for inflammation in P50=450 .00 ,WBC content of cancer hydrothorax was P50 = 1 750 .00 ,the difference was statistically significant ( P<0.01) .The level of inflammatory group hydrothorax supersensitivity C reactive protein is P 50 =15 .87 ,level of malig‐nant chest water level of high sensitive C reactive protein in group P50 =10 .07 ,no significant difference (P>0 .05) . Conclusion:It is very important to cell morphological examination on hydrothorax ,differential diagnosis of malignant pleural effusion has good specificity and sensitivity ,also has certain clinical significance in differential diagnosis of pleu‐ral effusion hydrothorax WBC count ,i .e .neoplastic and inflammatory pleural effusion compared ,its value is relatively high .And hydrothorax supersensitivity C reactive protein level detection failed to illustrate the identification of pleural effusion .
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