Плевральный выпот
Transudate vs. exudate |
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Transudate |
Exudate |
Main causes |
Increased hydrostatic pressure, Decreased colloid osmotic pressure |
Inflammation |
Appearance (внешний вид) |
Clear (чистый) |
Cloudy (опалесцирующий) |
Specific gravity (удельный вес) |
< 1.012 |
> 1.020 |
Protein content (содержание белка) |
< 2 g/dL |
> 2.9 g/dL[4] |
fluid protein serum protein |
< 0.5 |
> 0.5[5] |
Difference of albumin content with blood albumin (Отличие сод-ния альбумина с альбумином в крови) |
> 1.2 g/dL |
< 1.2 g/dL[6] |
fluid LDH upper limit for serum |
< 0.6 or < ⅔ |
> 0.6[4] or > ⅔[5] |
Cholesterol content (сод0ние холестерола) |
< 45 mg/dL |
> 45 mg/dL[4] |
Характеристика плеврального выпота
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Транссудат |
Экссудат |
Общепринятые тесты |
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Белок |
< 30 г/л |
> 30 г/л |
Лактатдегидрогеназа (ЛДГ) |
Низкая активность |
Высокая активность |
Отношения ЛДГ плевральной жидкости и ЛДГ сыворотки крови |
<0,6 |
>0,6 |
Специальные тесты |
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Эритроциты |
<10•109/л |
>100•109/л свидетельствует в пользу опухоли, инфаркта легкого, травмы: >10•109/л, но <:100•109/л — неопределенное диагностическое значение |
Лейкоциты |
< 1•109/л, обычно >50% из них лимфоциты или моноциты |
Обычно >1•109/л >50% лимфоцитов — характерно для туберкулеза или опухоли; >50% полиморфно-клеточных лейкоцитов — острое воспаление |
РН |
>7,3 |
<7,3 (в случае воспаления) |
Глюкоза |
Концентрация, близкая к гликемии |
Низкая (при инфекционном воспалении), резко снижена при ревматоидном артрите и особенно при опухолях |
Амилаза |
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>500 ед/мл (панкреатит, в редких случаях — опухоль, инфекционное воспаление) |
Специфические белки |
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Низкое содержание С3- и С4-фракций комплемента (системная красная волчанка, ревматоидный артрит). Обнаружение ревматоидного фактора, антинуклеарного фактора |
Arterial blood gas
Analyte |
Range |
Interpretation |
pH |
7.35–7.45 |
The pH or H+ indicates if a patient is acidemic (pH < 7.35; H+ >45) or alkalemic (pH > 7.45; H+ < 35). |
H+ |
35–45 nmol/L(nM) |
See above. |
PaO2 |
9.3–13.3kPa or 80–100 mmHg |
A low PaO2 indicates that the patient is not oxygenating properly, and is hypoxemic. (Note that a low PaO2 is not required for the patient to have hypoxemia.) At a PaO2 of less than 60 mm Hg, supplemental oxygen should be administered. At a PaO2 of less than 26 mmHg, the patient is at risk of death and must be oxygenated immediately.[citation needed] |
PaCO2 |
4.7–6.0 kPa or 35–45 mmHg |
The carbon dioxide partial pressure (PaCO2) is an indicator of CO2 production and elimination: for a constant metabolic rate, the PaCO2 is determined entirely by its elimination through ventilation.[7] A high PaCO2 (respiratory acidosis, alternatively hypercapnia) indicates underventilation (or, more rarely, ahypermetabolic disorder), a low PaCO2 (respiratory alkalosis, alternatively hypocapnia) hyper- or overventilation. |
HCO3− |
22–26 mmol/L |
The HCO3− ion indicates whether a metabolic problem is present (such as ketoacidosis). A low HCO3− indicates metabolic acidosis, a high HCO3− indicatesmetabolic alkalosis. As this value when given with blood gas results is often calculated by the analyzer, correlation should be checked with total CO2 levelsas directly measured (see below). |
SBCe |
21 to 27 mmol/L |
the bicarbonate concentration in the blood at a CO2 of 5.33 kPa, full oxygen saturation and 37 Celsius.[8] |
Base excess |
−2 to +2 mmol/L |
The base excess is used for the assessment of the metabolic component of acid-base disorders, and indicates whether the patient has metabolic acidosis or metabolic alkalosis. Contrasted with the bicarbonate levels, the base excess is a calculated value intended to completely isolate the non-respiratory portion of the pH change.[9] |
total CO2(tCO2 (P)c) |
25 to 30 mmol/L |
This is the total amount of CO2, and is the sum of HCO3− and PCO2 by the formula: tCO2 = [HCO3−] + α*PCO2, where α=0.226 mM/kPa, HCO3− is expressed in millimolar concentration (mM) (mmol/l) and PCO2 is expressed in kPa [10] |
O2 Content (CaO2, CvO2, CcO2) |
vol% (mL oxygen/dL blood) |
This is the sum of oxygen dissolved in plasma and chemically bound to hemoglobin as determined by the calculation: CaO2 = (PaO2 * 0.003) + (SaO2 * 1.34 * Hgb) where hemoglobin concentration is expressed in g/dL.[11] |