| 摘要: |
| ［摘要］ 目的 探讨各种疾病所致的胸腔积液中分泌型白细胞蛋白酶抑制因子的水平及其临床意义。方法 收集85例胸腔积液及其同源外周血(分为四组，其中结核性胸腔积液组为29例，恶性胸腔积液组30例，细菌性胸腔积液组15例，漏出液组11例)。应用ELISA法测定胸水上清液和血清中分泌型白细胞蛋白酶抑制因子(SLPI)的浓度，并对结果及意义进行分析。结果 （1）胸腔积液间：结核组浓度(21 1710±29 130)pg/ml，分别与肿瘤组(99 274±21 807)pg/ml、细菌组(127 980±34 299)pg/ml及漏出液组(109 360±21 619)pg/ml相比，差异均有统计学意义（P<0.05）；肿瘤组、细菌组及漏出液组三组之间相比差异均无统计学意义（P>0.05）。（2）血清中：结核组(35 116±4 122.1)pg/ml及肿瘤组(2 5767±2 054)pg/ml分别与漏出液组(51 377±10 190)pg/ml相比差异有统计学意义（P<0.05）；漏出液组与细菌组(52 396±8 954.5)pg/ml比较差异无统计学意义，结核组、肿瘤组及细菌组之间差异亦无统计学意义（P>0.05）。 （3）胸腔积液与血清液间：结核组、肿瘤组与漏出液组之间差异有统计学意义（P<0.05）；而在细菌组差异无统计学意义（P>0.05）。（4） 各组胸腔积液与同源外周血清之间无相关性（P>0.05）。（5）受试者工作特征曲线(ROC曲线)结果显示:胸腔积液中SLPI浓度对结核性胸腔积液的最佳诊断阈值为23 6071 pg/ml，相应灵敏度和特异度分别为43.33%和96.77%。结论 白细胞蛋白酶抑制因子(SLPI)有可助于结核性与恶性、细菌性及漏出性胸腔积液的鉴别。SLPI浓度测定有可能成为结核性胸腔积液的新诊断方法。 |
| 关键词: 分泌型白细胞蛋白酶抑制因子(SLPI) 胸腔积液 |
| DOI：10.3969/j.issn.1674-3806.2011.08.12 |
| 分类号:R 561 |
| 基金项目: |
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| The level and meaning of secretory leukocyte protease inhibitor in pleural effusion |
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WU Cong，FENG Ting-mei，WU Yan-bin
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Institute of Respiratory Diseases, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021,China
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| Abstract: |
| ［Abstract］ Objective To investigate the concentrations and clinical significance of secretory leukocyte protease inhibitor (SLPI) in pleural effusions with various etiologies. Methods Pleural effusion samples were obtained from 85 patients who presented to the respiratory institute (29 with tuberculous pleural effusion, 30 with malignant pleural effusion, 15 with bacterial pleural effusion and 11 with transudative pleural effusion). The pleural effusion and serum levels of SLPI were determined by sandwich enzyme-linked immunosorbent assays (ELISA). Results （1）In pleural effusion, the concentrations of SLPI in tuberculous pleural effusion (21 1710±29 130)pg/ml was significantly higher than that in malignant group (99 274±21 807)pg/ml, in bacterial group (127 980±34 299)pg/ml and in transudative group (109 360±21 619)pg/ml (P<0. 05). But there were no statistical significance among the malignant group, bacterial group and transudative group (P>0. 05). （2）In serum, the tuberculous group (35 116±4 122. 1)pg/ml and malignant group (25 767±2 054)pg/ml were higher that in transudative group (5 1377±10 190)pg/ml (P<0. 05). There was no difference between bacterial group (52 396±8 954. 5)pg/ml and transudative group (P>0. 05), there were also no statistical significance among the tuberculous group, malignant group and bacterial group (P>0. 05). （3）Between pleural effusion and serum, there were statistical significance in tuberculous group, malignant group and transudative group (P<0. 05), but not in bacterial group(P>0. 05). （4）The pleural levels of SLPI was no correlated with the corresponding serum levels (P>0. 05). （5）The cut-off value of pleural SLPI for the diagnosis of tuberculous pleural effusion was 236071pg/mL with the corresponding sensitivity and specificity 0. 433 and 0. 968, respectively. Conclusion Pleural SLPI may be helpful for the differential diagnosis of tuberculous pleural effusion and the other pleural effusion, and the detection of pleural SLPI could be a new tool to diagnose tuberculous pleural effusion. |
| Key words: Secretory leukocyte protease inhibitor(SLPI) Pleural effusion |
