Akurasi Pemeriksaan Protein, Kolesterol dan Laktat Dehidrogenase Cairan Pleura dalam Membedakan Efusi Pleura Transudat dan Eksudat

Abstract

Backgroud: Differentiating exudative and transudative pleural effusion is essential for further appropriate workup and treatment. Many studies have evaluated pleural fluid lactate dehydrogenase (pLDH), protein (pProt) and cholesterol (pChol) for that purpose. Previously however, there is no study has shown the strength of diagnostic combination from those three parameters Objective: To evaluate the benefit of three pleural fluid parameters pLDH, pProt and pChol both in single or combination form for differentiating exudative and transudative pleural effusion. Methods: Sixty six cases of pleural effusion at Adam Malik Central Hospital from January-Mei 2014 were divided into exudate (56) and transudate group (10) based on their definite clinical diagnosis. Furthermore, comparations were made between all parameters in single and combination form to evaluate the strength between those criteria in order to differentiate between exudate and transudate pleural fluid. Results: All parameters both in single or combination form were statistically different (p < 0,05) between exudate and transudate. However, the combination of two or more from three parameters (pLDH+pProt I pLDH+pChol / pProt+pChol / pLDH+pProt+pChol) were found superior in accuracy (92,4%), sensitivity (94,6%), and NPV (75%) compare to others. Conclusion: This study found that combination of two or more from three parameters (pLDH, pProt and pChol) has superiority in differentiating exudate and transudate pleural fluid