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目的 研究结核性及恶性胸腔积液患者胸液及血清中肿瘤坏死因子 (TNF)、白细胞介素 8(IL 8)、胸液中可溶性细胞间粘附分子 1(sICAM 1)及外周血多形核白细胞 (PMN)上粘附分子CD11b/CD18在参与胸膜病变的病理生理过程中的作用和在鉴别诊断上的价值。方法 采用放射免疫分析法 (RIA法 )、双抗体夹心ELISA法以及流式细胞仪技术 ,检测 31例结核性、31例恶性胸腔积液患者胸液和 (或 )血清中TNF、IL 8、sICAM 1和CD11b/CD18表达水平 ,并与 31例健康献血者对照。结果 结核性和恶性胸腔积液患者血清中TNF、IL 8含量以及PMN上CD11b/CD18表达显著高于正常对照组 (P <0 0 1) ,结核性胸液中TNF与IL 8水平和血PMN上CD11b/CD18表达明显高于恶性胸液患者 (P <0 0 1) ,结核性胸液中sICAM 1水平明显低于恶性胸液 (P <0 0 1)。胸腔积液中TNF与IL 8、sICAM 1水平呈显著正相关 (r=0 74和r =0 79,P <0 0 1) ,血清TNF与PMN上CD11b/CD18的表达呈显著正相关 (r=0 6 1,P <0 0 1) ,胸腔积液中sICAM 1水平与血PMN上CD11b/CD18的表达呈显著负相关 (经作曲线拟合 ,Y =144 2 31- 36 85X + 0 2 5X2 ,R2 =0 5 9,F =19 83,P <0 0 1)。结论 细胞因子TNF、IL 8和粘附分子sICAM 1、CD11b/CD18相互联系 ,在结核和肿瘤性胸膜病变
Objective To study the expression of tumor necrosis factor (TNF), interleukin 8 (IL 8), soluble intercellular adhesion molecule 1 (sICAM 1) in pleural effusion and peripheral blood polymorphism in patients with tuberculous and malignant pleural effusion The role of adhesion molecule CD11b / CD18 in nuclear leukocytes (PMN) in the pathophysiological process involved in pleural diseases and its value in differential diagnosis. Methods Radioimmunoassay (RIA), double antibody sandwich ELISA and flow cytometry were used to detect the levels of TNF, IL 8 and sICAM in 31 cases of tuberculous and 31 cases of malignant pleural effusion. 1 and CD11b / CD18 expression, and with 31 healthy blood donors control. Results The levels of TNF and IL-8 in serum and the expression of CD11b / CD18 on PMN in patients with tuberculous and malignant pleural effusion were significantly higher than those in normal control group (P <0.01). The levels of TNF and IL-8 in tuberculous pleural effusion and blood PMN The expression of CD11b / CD18 was significantly higher in malignant pleural effusion than in malignant pleural effusion (P <0.01). The sICAM 1 level in tuberculous pleural effusion was significantly lower than that in malignant pleural effusion (P <0.01). There was a significant positive correlation between TNF and IL-8 and sICAM1 levels in pleural effusion (r = 0 74 and r = 0 79, P 0 01), and a significant positive correlation between serum TNF and CD11b / CD18 on PMN = 0 6 1, P 0 01). There was a significant negative correlation between the level of sICAM 1 in pleural effusion and the expression of CD11b / CD18 on PMN (curve fitting, Y = 144 2 31-36 85X + 0 2 5X2, R2 = 0 5 9, F = 19 83, P <0 0 1). Conclusion Cytokines TNF, IL 8 and sICAM 1, CD11b / CD18 are correlated with each other. In tuberculosis and neoplastic pleural diseases