Rıdvan CEVLİK, Engin OZAKİN, Huseyin YİLDİRİM, Esref GENC, Nurdan ACAR, Filiz Baloglu KAYA, Mustafa Emin CANAKCİ

Transuda ve Eksüdayı Ayırt Etmek için Plevral Laktat Ölçümünün Kullanılabilirliği

Çalışmamız, plevral efüzyonlu hastalarda transüda ve eksüdayı ayırt etmenin güvenilirliğini ve geçerliliğini belirleyerek plevral laktat düzeylerini değerlendirmeyi amaçladı.1 Temmuz 2017 ile 31 Ocak 2018 tarihleri arasında bir üniversite hastanesine başvuran ve plevral efüzyon tanısı alan hastalar üzerinde yapılan prospektif, gözlemsel bir çalışmadır. Transüda ve eksüda plevral sıvı sınıflandırması Light kriterlerine göre yapılmıştır. Çalışma grubu pevral effüzyonlu toplam 169 hastadan oluştu [99 (% 58.6) erkek ve 18-93 yaş arası (ortalama ± SS, 64.6 ± 16.1 yıl)]. Hastaların 44'ü (% 26) eksüda ve 125'i transüda olarak değerlendirildi. Laktatın ortanca değeri eksüda hastalarda 3.20 mmol / L (min-maks: 0.90-14.3) ve transüda hastalarda 1.85 mmol / L (min-maks: 0.90-4.70) idi ve her ikisinin karşılaştırılmasında anlamlı farklılık saptandı. (z: 5.894; p <0.001). Plevral laktat seviyeleri ile plevral LDH, plevral LDH / serum LDH ve plevral protein / serum protein oranları arasında pozitif bir korelasyon tespit edildi. En yüksek duyarlılık ve özgüllük için plevral sıvı laktat düzeyinin kestirim değeri 2.0 olarak belirlendi (duyarlılık:% 85, özgüllük:% 64, AUC: 0.799). Plevral sıvıda laktat seviyelerinin ölçümü, transüda ve eksüda sıvısının ayrımı için yararlı olabilir. Ayrıca laktat seviyesinin çok kısa sürede tespiti diğer stratejilere göre daha kullanışlı bir tarama aracı olarak kullanılabilir.

Anahtar Kelimeler:

pleural, lactate, trasudate, exudate

The Usefulness of Pleural Lactate Measurement for Differentiating Transudate and Exudate

Our study aimed to evaluate pleural lactate levels, to identify the reliability and validity of determining pleural fluid quality in patients with pleural effusion.This is a prospective, observational study conducted on patients who were admitted to a university hospital between July 1, 2017, and January 31, 2018, and diagnosed with pleural effusion. Pleural fluid classification into transudates and exudates was made according to Light’s criteria. The study group consisted of a total of 169 patients with pleural effusion, [99 (58.6%) male and aging 18-93 years (mean ± SD, 64.6 ± 16.1 years)]. Forty-four (26%) of the patients were evaluated as exudate and 125 (74%) as transudate. The median value of lactate was 3.20 mmol/L (min-max: 0.90-14.3) in exudate patients and 1.85 mmol/L (min-max: 0.90-4.70) in transudate patients, and a significant difference was detected in the comparison of both (z: 5.894; p<0.001). There was a positive correlation between pleural lactate levels and pleural LDH, pleural LDH/serum LDH and pleural protein/serum protein ratios. The cut-off value of the pleural fluid lactate level was determined to be 2.0 for the highest sensitivity and specificity (sensitivity: 85%, specificity: 64%; AUC: 0.799). Measurement of lactate levels in pleural fluid can be useful for the differentiation of transudate and exudate fluid. Moreover, detection of lactate levels in a very short period may provide a more useful screening tool compared to other strategies.

Keywords:

transuda, eksuda, plevral laktat,

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