Proinflammatory and Antiinflammatory Cytokine Levels in Complicated and Noncomplicated Parapneumonic Pleural Effusions
Proinflammatory and Antiinflammatory Cytokine Levels in Complicated and Noncomplicated Parapneumonic Pleural Effusions
复制标题
DOI：
10.1378/chest.10-3181
复制
发表时间：
2012-01-01
期刊：
影响因子：
9.6
通讯作者：
Light, Richard W.
中科院分区：
文献类型：
--
作者：
Marchi, Evaldo;Vargas, Francisco S.;Light, Richard W.
目的：本研究旨在评估非并发症和并发症肺旁胸腔积液中的促炎和抗炎细胞因子，并探讨其水平与胸腔液生化参数的相关性。方法：收集60例无并发症（26例）或并发症（34例）肺旁积液患者的血清和胸腔积液，进行细胞学、生化、促炎和抗炎细胞因子检测。采用学生t检验比较血清和胸腔积液值，Spearman相关性分析胸腔积液细胞因子与生化参数的关系，准确性分析胸腔积液细胞因子水平确定复杂积液鉴别的最佳临界值。对多重比较进行校正，P值< 0.05为显著性。结果：两组血清和胸膜液细胞因子IL-8、血管内皮生长因子（VEGF）、IL-10和肿瘤坏死因子（TNF）可溶性受体（sR） II水平相近。相比之下，复杂积液中胸膜液IL-1 β、IL-1受体拮抗剂（ra）和TNF - sRI水平较高。胸水葡萄糖与IL-1 β和TNF - sRI呈负相关，乳酸脱氢（LDH）与IL-1 β、IL-8和VEGF呈正相关。胸膜液IL-1 β、IL-1ra和TNF - sRI水平在鉴别复杂积液方面比IL-8、VEGF、IL-10和TNF - sRII更准确。结论：与非并发症肺旁胸腔积液相比，并发症胸腔积液中促炎和抗炎细胞因子水平均升高，并与胸腔积液葡萄糖和LDH水平相关。IL-1 β、IL-1ra、TNF - sRI鉴别复杂积液的敏感性和特异性均高于IL-8、VEGF、IL-10、TNF - sRII。胸部2012;141 (1): 183 - 189
Objectives: This study aimed to evaluate a panel of proinflammatory and antiinflammatory cytokines in noncomplicated and complicated parapneumonic pleural effusions and to correlate their levels with pleural fluid biochemical parameters.Methods: Serum and pleural effusion were collected from 60 patients with noncomplicated (n = 26) or complicated (n = 34) parapneumonic effusions and assayed for cytologic, biochemical, and proinflammatory and antiinflammatory cytokines. Student t test was used to compare serum and pleural fluid values, Spearman correlation to analyze the relationship between pleural fluid cytokines and biochemical parameters, and accuracy of pleural fluid cytokine levels to determine the optimal cutoff value for identification of complicated effusions. Corrections for multiple comparisons were applied and a P value < .05 was accepted as significant.Results: Serum and pleural fluid cytokine levels of IL-8, vascular endothelial growth factor (VEGF), IL-10, and tumor necrosis factor (TNF) soluble receptor (sR) II were similar between groups. In contrast, complicated effusions had higher levels of pleural fluid IL-1 beta, IL-1 receptor antagonist (ra), and TNF sRI. Negative correlations were found between pleural fluid glucose with IL-1 beta and TNF sRI and positive correlations between lactic dehydrogenate (LDH) with IL-1 beta, IL-8, and VEGF. Pleural fluid levels of IL-1 beta, IL-1ra, and TNF sRI were more accurate than IL-8, VEGF, IL-10, and TNF sRII in discriminating complicated effusions.Conclusions: Both proinflammatory and antiinflammatory cytokine levels in pleural fluid are elevated in complicated in comparison with noncomplicated parapneumonic pleural effusions, and they correlate with both pleural fluid glucose and LDH levels. IL-1 beta, IL-1ra, and TNF sRI had higher sensitivity and specificity than IL-8, VEGF, IL-10, and TNF sRII in discriminating complicated effusions. CHEST 2012; 141( 1):183-189