【摘要】：目的:探討惡性胸腔積液(MPE)和結(jié)核性胸腔積液(TPE)患者胸腔積液及相應(yīng)外周血中白細(xì)胞介素33(IL-33)和可溶性ST2(sST2)表達(dá)水平,闡明其臨床意義。方法:選擇72例胸腔積液患者(其中MPE 42例,TPE 30例),采用酶聯(lián)免疫吸附測(cè)定(ELISA)法檢測(cè)胸腔積液和外周血IL-33和sST2表達(dá)水平,另選本院體檢正常者38人為健康對(duì)照組。比較MPE、TPE患者和健康對(duì)照組受試者胸腔積液和血清中IL-33及sST2表達(dá)水平,分析2組患者胸腔積液和血清中IL-33和sST2表達(dá)水平的相關(guān)性。采用受試者工作特征曲線(ROC曲線)確定IL-33表達(dá)水平和sST2/IL-33比值鑒別MPE和TPE的閾值及其特異度和敏感度。結(jié)果:MPE和TPE患者血清中IL-33和sST2表達(dá)水平比較差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05),但均明顯高于健康對(duì)照組(P0.01)。TPE患者胸腔積液中IL-33表達(dá)水平明顯高于其相應(yīng)血清水平(P0.01),MPE患者胸腔積液中IL-33表達(dá)水平明顯低于其相應(yīng)血清水平(P0.05),TPE患者胸腔積液中IL-33表達(dá)水平明顯高于MPE患者(P0.05)。MPE患者胸腔積液中sST2表達(dá)水平明顯高于TPE患者(P0.01)。MPE和TPE患者胸腔積液中IL-33水平與其相應(yīng)血清中IL-33水平均呈正相關(guān)關(guān)系(rMPE=0.930 4,rTPE=0.990 7,P0.05);MPE患者胸腔積液中sST2水平與其相應(yīng)血清中sST2水平呈正相關(guān)關(guān)系(r=0.934 5,P0.05),但TPE患者胸腔積液中sST2水平與其相應(yīng)血清中sST2水平無(wú)相關(guān)性。ROC曲線結(jié)果,鑒別TPE和MPE的胸腔積液中IL-33表達(dá)水平的最佳閾值為17.08ng·L~(-1),相應(yīng)敏感度和特異度分別為96.7%和92.9%;胸腔積液中sST2/IL-33比值鑒別TPE和MPE的最佳閾值為15.06,相應(yīng)敏感度和特異度分別為96.8%和95.5%。結(jié)論:IL-33和sST2不同程度地參與了TPE和MPE的胸膜炎癥反應(yīng)。監(jiān)測(cè)胸腔積液中IL-33表達(dá)水平和sST2/IL-33比值可能是鑒別良、惡性胸腔積液的新方法,有較高的臨床應(yīng)用價(jià)值。
[Abstract]:Objective: to investigate the expression levels of interleukin-33 (IL-33) and soluble ST2 (sST2) in pleural effusion (MPE) and tuberculous pleural effusion (TPE) in patients with malignant pleural effusion and tuberculous pleural effusion, and to elucidate its clinical significance. Methods: the expression of IL-33 and sST2 in pleural effusion and peripheral blood of 72 patients with pleural effusion (including 42 patients with MPE and 30 patients with MPE) were detected by (ELISA) assay. 38 normal subjects were selected as healthy control group. To compare the expression levels of IL-33 and sST2 in pleural effusion and serum of MPE,TPE patients and healthy control subjects, and to analyze the correlation between the expression levels of IL-33 and sST2 in pleural effusion and serum of the two groups. The threshold, specificity and sensitivity of MPE and TPE were identified by using the ROC curve to determine the expression level of IL-33 and the ratio of sST2/IL-33. Results there was no significant difference in the expression of IL-33 and sST2 between the two groups (P0.05), but they were significantly higher than those in the control group (P0.01). The expression of IL-33 in the pleural effusion of the patients with TPE was significantly higher than that in the patients with MPE (P0.01). The expression of IL-33 in pleural effusion in patients with IL-33 was significantly lower than that in patients with MPE (P0.05). The expression of sST2 in pleural effusion in patients with MPE was significantly higher than that in patients with TPE (P0.01). MPE and IL-33 in pleural effusion of TPE patients. There was a positive correlation between sST2 level in pleural effusion and sST2 level in corresponding serum (P 0.05), but sST2 level in pleural effusion of TPE patients and sST2 level in corresponding serum were positively correlated (P 0.05). No correlation. ROC curve results, The optimal threshold of IL-33 expression in pleural effusion of TPE and MPE was 17.08ng L-1, and the corresponding sensitivity and specificity were 96.7% and 92.9%, respectively, and the optimum threshold of sST2/IL-33 ratio in pleural effusion was 15.06, and the corresponding sensitivity and specificity were 96.8% and 95.5%, respectively. Conclusion: 1-IL-33 and sST2 are involved in pleural inflammation of TPE and MPE to varying degrees. Monitoring the expression level of IL-33 and the ratio of sST2/IL-33 in pleural effusion may be a new method for differentiating benign and malignant pleural effusion.
【作者單位】： 吉林大學(xué)第一醫(yī)院呼吸內(nèi)科;
【基金】：吉林省發(fā)改委科研基金資助課題(JF2016C0061)
【分類號(hào)】：R521.7;R730.43

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