Markedly elevated cytokines in pleural effusion during the ovarian hyperstimulation syndrome: Transudate or ascites?
Markedly elevated cytokines in pleural effusion during the ovarian hyperstimulation syndrome: Transudate or ascites?
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DOI：
10.1016/s0015-0282(97)81383-0
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发表时间：
1997-04-01
影响因子：
6.7
通讯作者：
Friedlander, MA
中科院分区：
文献类型：
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作者：
deMola, JRL;ArredondoSoberon, F;Friedlander, MA
目的：研究重度卵巢过度刺激综合征(OHSS)患者胸腔积液中促炎症细胞因子的水平。设计：病例报告。地点：三级医学中心。患者(S)：35岁，女性，有B年原因不孕史，接受促性腺激素治疗，对照组28例。干预(S)：严重胸腔积液及静脉穿刺术。主要观察指标(S)：采用双抗体夹心ELISA法检测胸腔积液中白介素1β(IL-1β)、白介素6(IL-6)、肿瘤坏死因子-α(TNF-α)水平，并与正常对照组胸腔积液及血清中肿瘤坏死因子-α水平进行比较。结果(S)：胸腔积液IL-1β、IL-6水平均高于血清。IL-6水平在胸腔积液(1,961.89 pg/m L)较血清(3.9+/-0.41pg/m L)明显升高。结论：我们的研究结果证实了细胞因子在OHSS中的高水平。细胞因子与毛细血管通透性、液体外渗、少尿和休克有关。我们推测这些介质是从黄体释放到腹膜和体循环的。另一种情况是，胸液中细胞因子水平升高可能是由于横隔膜的缺陷导致腹水向胸膜腔内迁移。(C)1997年由美国生殖医学学会主办。
Objective: To study levels of proinflammatory cytokines in pleural fluid during the severe ovarian hyperstimulation syndrome (OHSS).Design: Case report.Setting: Tertiary academic medical center.Patient(s): A 35-year-old female with a B-year history of unexplained infertility on menotropin therapy and 28 healthy normal controls.Intervention(s): Thoracentesis for severe pleural effusion and venipunctures.Main Outcome Measure(s): Interleukin-1 beta (IL-beta), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-alpha) levels were measured by ELISA and compared between pleural effusion and serum from normal controls. Result(s): Pleural effusion IL-1 beta and IL-6 levels were higher than serum. Interleukin-6 levels were elevated particularly in pleural effusion (1,961.89 pg/mL) compared with serum (3.9 +/- 0.41 pg/mL).Conclusion(s): Our results confirm the high cytokine levels observed in OHSS. Cytokines have been implicated in capillary permeability, extravasation of fluid, oliguria, and shock. We have postulated that these mediators are released from the corpora lutea into the peritoneum and systemic circulation. Alternatively, the presence of high cytokine levels in pleural fluid maybe the result of diaphragmatic defects, which allow for the migration of ascites into the pleural space. (C) 1997 by American Society for Reproductive Medicine.