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背景:胸膜增厚(RPT)后遗症是结核性胸膜炎(TP)最常见的合并症。RPT的程度事先不能预测。 目的:判定胸膜腔渗液的各种成分是否对RPT的发生有影响。 设计:47例TP入选。胸液进行了一系列生化试验,共包括:乳酸脱氢酶、葡萄糖、总蛋白、腺苷脱氨酶、α肿瘤坏死因子(TNF-α)、α_1酸性糖蛋白(AAG)、α_2巨球蛋白、C反应蛋白(CRP)、补体3、补体4。经6个月抗结核治疗后,再次评定病人胸膜增厚情况。后前位胸片,测量横膈顶水平以下侧胸壁胸膜的厚度,>2mm或>10mm定为胸膜增厚。 结果:胸膜增厚<2mm者17例(36.17％),增厚2—10mm者18例(38.29％),>10mm者12例(25.53％)。<2mm组TNF-α水平低于2-10mm组及>10mm组(各为P<0.05及P<0.001),胸膜增厚>10mm组胸液中TNF-α水平高于增厚2-10mm组(P<0.05)。同时增厚10mm以上组胸液中葡萄糖、AAG及CRP水平显著高于<2mm组(各为p<0.05,p<0.01及p<0.05)。 结论:结核性胸膜炎病人中,胸膜增厚程度与胸液中葡萄糖、CRP、AAG及TNF-α显著相关。
BACKGROUND: Pleural thickening (RPT) sequelae are the most common comorbidities of tuberculous pleurisy (TP). The extent of RPT can not be predicted in advance. Objective: To determine whether various components of pleural effusion have an impact on the occurrence of RPT. Design: 47 cases of TP selected. A series of biochemical tests were performed on pleural fluid including lactate dehydrogenase, glucose, total protein, adenosine deaminase, alpha tumor necrosis factor (TNF-alpha), alpha 1 acid glycoprotein (AAG), alpha 2 macroglobulin , C-reactive protein (CRP), complement 3, complement 4. After 6 months of anti-TB treatment, re-evaluation of patients with pleural thickening. After the anterior chest radiograph, measuring the thickness of the pleural space below the level of the top of the diaphragm,> 2mm or> 10mm as pleural thickening. Results: Pleural thickening <2mm in 17 cases (36.17%), thickening of 2-10mm in 18 cases (38.29%),> 10mm in 12 cases (25.53%). The level of TNF-α in <2mm group was lower than that in 2-10mm group and> 10mm group (P <0.05 and P <0.001 respectively), and the level of TNF-α in pleural fluid was higher in group with pleural thickening> 10mm than that in group with thickness 2-10mm (P <0.05). At the same time, the levels of glucose, AAG and CRP in pleural effusion of 10mm thick group were significantly higher than those in <2mm group (p <0.05, p <0.01 and p <0.05 respectively). CONCLUSIONS: Pleural thickening is associated with glucose, CRP, AAG and TNF-α in pleural fluid in patients with tuberculous pleurisy.