摘要
目的探究结核性脓胸患者胸腔积液中炎症因子中白细胞介素1β(Interleukin 1,IL-1β)、白细胞介素2(Interleukin 2,IL-2)、白细胞介素6(Interleukin 6,IL-6)、白细胞介素8(Interleukin 8,IL-8)、肿瘤坏死因子(Tumor necrosis factor-α,TNF-α)、纤溶酶原激活物抑制剂-1(Plasminogen activator inhibitor,PAI-1)和组织型纤溶酶原激活物(Tissue-type plasminogen activator,t-PA)等炎症因子水平在治疗前后的变化,并探讨不同治疗方法对结核性脓胸患者免疫功能的影响。方法为了实现预期实验目的,将上述患者进行如下分组:结核性胸膜炎组(n=33),结核性脓胸组(n=29),闭式引流组(n=17),手术组(n=12)。通过压阀式胸腔穿刺针对胸腔积液进行取样,通过酶联反应试剂盒对相关炎症因子进行测定。结果 IL-1β、TNF-α和PAI-1水平在结核性脓胸患者中显著升高,IL-8和t-PA水平在结核性脓胸患者中显著降低。当给予29例结核性脓胸患者接受治疗时,其中17例患者接受胸腔闭式引流治疗,12例患者接受手术治疗;在闭式引流治疗组中IL-2、IL-6、IL-8和TNF-α水平显著升高,而IL-1β和PAI-1水平显著降低。结论 IL-1β、IL-8、TNF-α、PAI-1和tPA等炎症因子的水平在结核性胸膜炎与结核性脓胸患者的胸腔积液中存在显著性差异;且从炎症因子水平判断,在结核性脓胸患者治疗中闭式引流术治疗效果优于手术治疗,闭式引流术对于机体免疫功能损伤程度更小。
Objective To investigate the changes of inflammatory factors IL-1β,IL-2,IL-6,IL-8,TNF-α,PAI-1 and t-PA in pleural effusion in patients with tuberculous pleurisy and tuberculous empyema,so as to explore the effect of different treatments on immune function of patients with tuberculous empyema.Methods In order to achieve the desired experimental purpose,the patients were divided into the following groups:the tuberculous pleurisy group(n=33),the tuberculous empyema group(n=29),the closed drainage group(n=17),and the operation group(n=12).The pleural effusion was sampled by pressure-type thoracic puncture.The related inflammatory factors were measured by enzyme-linked reaction kit.Results The levels of IL-1,TNF-α,and PAI-1 were significantly higher in patients with tuberculous empyema,and IL-8 and t-PA levels were significantly lower in tuberculous empyema patients.When given to 29 patients with tuberculous empyema,17 cases underwent closed thoracic drainage and anti tuberculosis chemotherapy,and 12 patients received surgical treatment.In closed drainage,IL-6,IL-8 and IL-2 increased significantly in the treatment group,the levels of TNF-α,IL-1 and PAI-1 decreased significantly.Conclusion IL-1β,IL-8,TNF-α,PAI-1 and t-PA levels have significant differences in tuberculous pleurisy and pleural effusion in patients with tuberculous empyema.Judging from the level of inflammatory factors,closed drainage treatment is better than surgical treatment,and closed drainage has lighter body damage.
作者
张翠云
李养军
ZHANG Cui-yun;LI Yang-jun(the Fifth Department of Internal Medicine,Xi’an Chest Hospital,Xi’an,Shaanxi 710101,China)
出处
《临床肺科杂志》
2018年第5期933-937,共5页
Journal of Clinical Pulmonary Medicine
关键词
炎症因子
结核性脓胸
结核性胸膜炎
inflammatory factors
tuberculous pleurisy
tuberculous empyema
