乳び胸の簡便な早期診断法

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  • A Simple Diagnostic Method for Chylothorax in an Early Stage

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The ratios of triglycerides, esterified cholesterol, free cholesterol, and phospholipids between pleural effusion and serum produce useful information for the diagnosis of chylothorax in an early stage. We can get a significantly higher ratio of triglycerides compared with those of the other three lipids in the chylothorax. In case A, whose serum triglyceride level was 280 mg/l, no chylomicron was detected by electrophoresis, and the ratios of triglycerides, esterified cholesterol, free cholesterol, and phospholipids levels were 0.64, 0.46, 0.47, and 0.46, respectively. Early stage of chylothorax was suspected. Two days later this diagnosis was confirmed by the detection of chylomicron and the higher triglyceride concentration in the pleural effusion than in the serum.<BR>There were two patients whose pleural effusion triglyceride levels were 380 mg/l and 390 mg/l. The former had chylothorax and the latter did not. This means that a diagnosis of chylothorax by the absolute value of pleural effusion triglyceride was not always possible.<BR>The new method, described here, would be a more precise method to diagnose chylothorax at an early stage.

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