胸液中一氧化氮合成酶、一氧化氮及肿瘤坏死因子的研究

Study on nitric oxide synthase,nitric oxide and tumor necrosis factor in different types of pleural effusion

目的探讨不同性质胸液中一氧化氮合成酶 (NOS)、一氧化氮 (NO)和肿瘤坏死因子(TNF)的变化及其意义。方法采用Griess法、酶联免疫法和比色法测定了 80例不同性质胸水中NOS、NO及TNF。结果结核性胸水、癌性胸水中NO及TNF水平显著高于正常人血清水平 (P <0 0 1) ;癌性胸水、结核性胸水中NOS、NO及TNF水平明显高于漏出液的水平 (P <0 0 1) ;癌性胸水中NO及TNF含量介于漏出性胸水和结核性胸水之间 (P <0 0 5或P <0 0 1)。NOS活性在癌性胸水中最高。胸液中TNF含量与NO呈正相关 (r=0 5 46 7,P <0 0 5 )。结论NOS、NO及TNF参与了胸膜组织免疫损伤及胸液渗出过程 ,检测胸液中NOS、NO及TNF含量有助于胸水性质的诊断。NOS与NO两者分离提示胸水为癌性。

Objective To elucidate the clinical significance of nitric oxide synthase(NOS),nitric oxide(NO)and tumor necrosis factor(TNF)in different types of pleural effusions. Methods NOS,NO and TNF in eighty patients different types pleural liquid were measured by Griess,ELISA and Colorimetric.Results Compares to the value in serum of normal controls the NO and TNF in tuberculose pleural liquid and carcinogenesic pleural effusions were higher significantly ( P <0.01);Compares to the value in pleural liquid transudates,the NOS,NO and TNF in tuberculose pleural liquid and carcinogenesic pleural effusions were significantly higher( P <0.01);The NO,and TNF in carcinogenesic pleural effusions were between those in tuberculose pleural liquid and those in pleural liquid transudeates( P <0.05 or 0.01).The NOS activity was highest in carcinogenesic pleural effusions.Positive correlation was showed that TNF and NO in pleural liquid (r =0.5467, P <0.05).Conclusion The NOS,NO and TNF may involve in the immune damage of pleural tissues and the process of pleural effusions.The measurement of NOS,NO and TNF in pleural effusions were helpful in differential diagnosis of pleural effusions.The separation of NO level and NOS activity in pleural effusions indicates that the pleural effusion was carcinogenesis.