丹参酮Ⅱ-A和地塞米松胸腔注射对结核性胸膜炎患者血清和胸腔积液中IL-6表达的影响

Effect of tanshinone Ⅱ-A and dexamethasone by intrathoracic injection on expression of IL-6 in serum and pleural fluid in patients with tuberculous pleurisy

目的比较丹参酮Ⅱ-A和地塞米松胸腔注射对结核性胸膜炎患者的血清和胸腔积液中IL-6表达水平的影响及疗效。方法 64例结核性胸膜炎患者均分为A组(胸腔注射丹参酮Ⅱ-A)和B组(胸腔注射地塞米松)。ELISA法检测用药前、用药后第3、6、9天外周血和胸腔积液中IL-6水平;胸部CT检查用药后1个月胸膜肥厚和胸腔积液吸收情况。结果用药后第3、6、9天两组胸腔积液和血清中IL-6水平均下降,且血清中IL-6水平降低程度小于胸腔积液(P<0.05),但组间比较无统计学差异(P>0.05)。用药1个月后,A、B组胸腔积液完全吸收率分别为81.25%和84.38%,胸膜肥厚发生率分别为18.75%和15.62%,组间比较无统计学差异(P>0.05)。结论胸腔注射丹参酮Ⅱ-A与地塞米松均可明显降低局部IL-6的表达,两者疗效相似。

Objective To compare the effect of tanshinone Ⅱ-A and dexamethasone by intrathoracic injection on expression of interleukin-6（IL-6） in serum and pleural fluid in patients with tuberculous pleurisy and their therapeutic efficacy.Methods Sixty-four tuberculous pleurisy patients were equally divided into group A（intrathoracic injection of sodium tanshinone Ⅱ-A sulfonate） and B（intrathoracic injection of dexamethasone）.ELISA was used to detect the expression of IL-6 in serum and pleural fluid before treatment and on the 3rd,6th,9th day after treatment.Thoracic CT scanning was performed to evaluate the conditions of pachyonysis pleurae and pleural fluid at one month after treatment.Results The expression of IL-6 was decreased more in pleural fluid than that in serum in both groups on the 3rd,6th,9th day after treatment（P0.05）,which had no significant difference between group A and B（P0.05）.The rates of complete absorption of pleural fluid were 81.25% and 18.75% and the incidence rates of pachyonysis pleurae were 84.38% and 15.62%,respectively,for groups of A and B at one month after treatment,which were not significantly different between two groups（P0.05）.Conclusion Intrathoracic injection of tanshinone or dexamethasone can remarkably decrease the expression of IL-6.Their therapeutic efficacy is similar in the patients with tuberculous pleurisy.