康莱特联合顺铂胸腔注入前后胸水PAI-1、TGF-β、TNF-α的测定

The Plasma Levels of PAI-1,TGF-β and TNF-α in Pleural Effusion before and after Intrapleural Injection of Kanglaite Combined with Cisplatin

目的:观察康莱特联合顺铂胸腔注入前后I型纤溶酶原激活物抑制剂(PAI-1)、转化生长因子β(TGF-β)、肿瘤坏死因子α(TNF-α)指标的变化,为明确其发生作用机制提供实验理论。方法:将患者随机分为联合用药组、康莱特组和顺铂组,在胸腔注药前及注药24、48h后取胸水标本,采用酶联免疫方法测定胸水中PAI-1、TGF-β和TNF-α的含量。结果:3组在注药24、48h后PAI-1、TGF-β、TNF-α含量均比治疗前升高,差别有统计学意义(P<0.05)。注药24h后PAI-1、TGF-β水平在3组间比较差别无统计学意义,而TNF-α在联合组要高于康莱特组和顺铂组,差别有统计学意义(P<0.05)。注药48h后PAI-1、TGF-β、TNF-α含量在联合组要高于康莱特组,差别有统计学意义(P<0.05)。结论:康莱特和顺铂联合用药后激活PAI-1、TGF-β、TNF-α等细胞因子,产生炎症反应并抑制纤溶活性,促进纤维蛋白生成和沉积并诱导胸膜粘连,其作用效果要优于单纯用康莱特或顺铂。

Objective： To detect the levels of plasminogen activator inhibitor-1 （PAI-1）, transforming growth factor-β （TGF-β）and tumor necrosis factor-α （TNF-α） in the pleural fluid before and after intrapleural injection of Kanglaite combined with Cisplatin, and the mechanisms thereof. Methods： Patients were randomly divided into three groups, the Kanglaite combined with Cisplatin group （combination treatment group）, Kangkaite group and Cisplatin group. The levels of PAI-1, TGF-β and TNF-α were determined by ELISA in pleural effusion 24 h and 48 h before and after intrapleural injection of medicine. Results： The levels of PAI-1, TGF-β and TNF-α were higher 24 h and 48 h after treatment compared with those of pre-treatment in three groups （P 〈 0.05）. There were no statistical significances in levels of PAI-1 and TGF-β 24 h after injection medicine in three groups. But the level of TNF-α was higher in the combination treatment group than that in Kangkaite and Cisplatin groups（P 〈 0.05）. After injection medicine 48 h, the levels of PAI-1, GF-β and TNF-α were higher in the combination treatment group than those in Kangkaite group （P 〈 0.05）. Conclusion： The treatment of Kanglaite combined with Cisplatin activates PAI-1, TGF-β and TNF-α cytokines and causes inflammatory, suppresses fibrinolytic activity. These cytokines promote fibrin and induce pleural adhesion.