[Biochemical study of the pleural fluid in exudative pleurisy]. / Biokhimicheskoe issledovanie plevral'noi zhidkosti pri ékssudativnykh plevritakh.

The authors relate the data on the importance of a biochemical analysis of the pleural fluid for the differential diagnosis of pleurisy and identification of the early signs of pleural fluid suppuration. For the purposes of the differential diagnosis between transudates and exudates measurements are made of the protein content and LDH activity in the pleural fluid. The exudate protein/serum protein and exudate LDH/serum LDH ratios are computed in necessary cases. The high prothrombin index (over 100%) and the level of lysozyme (over 25 (micrograms/ml) in the pleural fluid provide evidence in favour of the tuberculous etiology of pleurisy. The low level of glucose (under 2 mmol/l), high activity of LDH (over 6.2 mmol/l) and the negative ethanol test may point to the initial signs of exudate suppuration.

[A method of differentiating transudate and exudate]. / Sposob differentsiatsii transsudata i ékssudata.

A diagnostic value of pleural fluid alkaline phosphatase (AP) for transudate and exudate differentiation is shown. AP below and above 0.5 mumol/(ml.h) are characteristic of transudate and exudate, respectively.

[Pathogenetic agents in the complex treatment of patients with tuberculous pleurisy]. / Patogeneticheskie sredstva v kompleksnom lechenii bol'nykh tuberkuleznym plevritom.

Data on therapy of 257 patients with tuberculous pleurisy and the clinicoroentgenological outcomes at the hospitalization stage were studied. 180 of them were treated pathogenetically in addition to the use of etiotropic drugs. The pathogenetic treatment included the use of prednisolone, tuberculin, pyrogenal, phonophoresis or electrophoresis with heparin. For estimating the therapy efficiency x-ray criteria of the size of residual pleural lesions after exudate resolution were developed. It was shown that inclusion of the pathogenetic treatment into combined therapy of the patients with tuberculous pleurisy markedly increased its efficiency and led to more favourable clinicoroentgenological outcomes. The results were especially favourable with tuberculin and successive application of the pathogenetic treatment corresponding to the process phase.