胸腔积液中白细胞介素6、18的变化与意义

Diagnostic value of interleukin-6, interleukin-18 in pleural effusions

目的 探讨胸腔积液患者血清及胸腔积液中白细胞介素6(IL -6)、白细胞介素1 8(IL -1 8)的变化及其临床意义,并明确其在胸腔积液免疫发病机理中的作用。方法 应用双抗体夹心酶联免疫吸附测定法(ELISA)检测2 0例结核性胸腔积液患者、2 0例恶性胸腔积液和1 5例漏出性胸腔积液患者血清及胸腔积液中IL -6、IL -1 8的水平。结果 结核组胸腔积液中IL -6、IL- 1 8水平分别为(468.1±1 4 2 .4)和(759.3±2 85 .1 )pg/ml显著高于恶性组(2 2 0 .8±50 .7)和(2 73 .7±93 .7)pg/ml及漏出液组(36 .4±4 .8)和(40 .6±5 .4)pg/ml。结论 IL- 6、IL -1 8在结核性、肿瘤性和漏出性胸腔积液患者的表达水平不同,可作为临床上鉴别诊断的参考指标,在结核和肿瘤性胸膜病变局部的免疫病理生理过程中起着重要作用。

Objective To explore the significanc e of IL-6 and IL-18 in pleural effusions and/or in peripheral blood in formation o f pleural effusions, their possible roles in differential diagnosis and in the i mmunopathogenesis of pleural effusions.Methods The s erum and pleural effusions levels of IL-6 and IL-18 were measured using enzyme -linked immuno-sorbent assay (ELISA) method in 20 cases of tuberculosis pleura l effusion (Group A), 20 cases of malignant pleural effusion (Group B), and 15 p atients with transudative pleural effusion (Group C). Results In Group A the pleural fluid levels of IL-6 and IL-18 (468.1±142.4 ) and (759.3±285.1) pg/ml, respectively] were significantly higher than those o f the Group B (220.8±50.7) and (273.7±93.7) pg/ml, respectively, all significa nt at P<0.01] and Group C [(36.4±4.8) and (40.6±5.4) pg/ml, respectively, all significant at P<0.01].Conclusion IL-6 and IL-18 may be involved in the immunopathogenesis of pleural effusions, while pleural f luid IL-6 and IL-18 levels could be useful as an additional marker in the diff erential diagnosis for tuberculosis, malignant and transudative pleural effusion s.